Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with lymphomas are conventionally imaged with [67Ga]citrate for tumor detection and determination of dissemination. Fluorine-18-2-fluoro-2-deoxy-D-glucose [( 18F]FDG) is a radiopharmaceutical that accumulates into tissues where glucose utilization is enhanced, such as tumors. Six cancer patients (five non-Hodgkin's lymphomas, one endodermal retroperitoneal sinus carcinoma) were imaged with [18F]FDG and [67Ga]citrate whole-body scintigraphies in order to compare the sensitivities of these two tumor imaging radiopharmaceuticals. Among the five untreated lymphoma patients, two 67Ga scans and four [18F]FDG scans were positive; in the patient with the retroperitoneal carcinoma who had a positive [18F]FDG scan before treatment, both scans were negative after treatment. Fluorine-18 FDG may be a more sensitive tumor-detecting radiopharmaceutical for non-Hodgkin's lymphoma than [67Ga]citrate.
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PMID:Comparison of fluorine-18-2-fluorodeoxyglucose and gallium-67 citrate imaging for detection of lymphoma. 346 32

Glucose metabolism has been shown to be increased in neoplastic tissue. It has been suggested that high activity of glucose metabolism is associated with a high grade of malignancy of human cancer. We studied in vivo glucose metabolism in 22 patients with untreated non-Hodgkin's lymphoma with fluorine-18-fluorodeoxyglucose (FDG) and positron emission tomography (PET). FDG uptake in lymphoma deposits was measured blinded to clinical data, and compared with histologic classification and proliferative activity. Tracer uptake was measured by using two indices of FDG accumulation: the standardized uptake value (SUV) and the regional metabolic rate (rMR) for the tracer. The median SUV of the lymphomas was 8.5 (range, 3.5 to 31.0), and the median rMR 22.7 mumol/100 g/min (range, 9.0 to 124.3 mumol/100 g/min). A high FDG uptake in tumors was associated with high histologic degree of malignancy as defined by the Working Formulation (P = .005 for the SUV, and P = .04 for the rMR) or by the Kiel classification (P = .003 for the SUV, and P = .02 for the rMR). A high FDG accumulation was also associated with a high S-phase fraction (r = .786 for the SUV, P = .0002; and r = .774 for the rMR, P = .02). We conclude that in untreated non-Hodgkin's lymphomas high FDG uptake is associated with high histologic grade of malignancy and a high proliferation rate. This minimally invasive method may find application in assessing lymphoma lesions in patients who are poor candidates for surgery, and it may provide further information in cases where the grade of aggressiveness of lymphoma is not settled based on clinical or histologic data.
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PMID:Increased glucose metabolism in untreated non-Hodgkin's lymphoma: a study with positron emission tomography and fluorine-18-fluorodeoxyglucose. 757 59

The management of patients with treated malignant lymphomas requires functional methods to differentiate a residual soft tissue mass. Patients with treated Hodgkin's lymphoma (HL, n = 20, 68 malignant lesions, three benign lesions) or non-Hodgkin's lymphoma (NHL, n = 26, 46 malignant lesions, one benign lesion) were studied with positron emission tomography (PET) and fluorine-18 deoxyglucose (FDG). Oxygen-15 labelled water was used (n = 14, 25 lesions) in addition to FDG in order to obtain information on the tissue perfusion. Long-term follow-up studies with PET and FDG were performed in nine patients up to 511 days after the initiation of second-line therapy. Fourteen patients underwent single-photon emission tomography (SPET) with technetium-99m sestamibi immediately prior to the first PET examination. PET with FDG displays a high sensitivity for the detection of viable tumour tissue, all the malignant lesions being correctly classified in this study. The possible limitations are inflammatory processes, which may obscure tumour detection due to increased FDG uptake, and malignant lesions with low FDG uptake due to reduced perfusion. Difficulties exist in the prognosis of long-term response, since the change in FDG uptake may be variable. Long-term therapy outcome was correlated with the slope values obtained from the standardized integral uptake (SIU) data, which provides a new approach for the evaluation of PET follow-up studies. 99mTc-sestamibi, which should reflect the multidrug resistance, was evaluated with respect to therapy outcome. A high uptake of 99mTc-sestamibi was observed in patients with stable disease or better. The data support the hypothesis that sestamibi may reflect multidrug resistance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of tumour metabolism and multidrug resistance in patients with treated malignant lymphomas. 764 52

The management of patients who have malignant lymphomas requires functional methods to differentiate residual soft tissue masses. Positron emission tomography (PET) was performed in patients with histologically proven malignant lymphomas prior to the onset of second-line chemotherapy to examine tumor viability. Twenty patients (68 malignant lesions and 3 benign lesions) with Hodgkin lymphomas (HL) as well as 26 patients (46 malignant lesions and 1 benign lesion) with non-Hodgkin lymphomas (NHL) were studied with fluorine-18-deoxyglucose (FDG). Oxygen-15-labelled water was used in addition in 14 patients with 25 lesions to obtain information on the tissue perfusion. PET with FDG is highly sensitive for the detection of viable tumor tissue, all malignant lesions being correctly classified in this study. We noted no statistically significant difference in FDG metabolism for Hodgkin and non-Hodgkin lymphomas. Even normal-sized lymph-node metastases (< 1 cm) were detected with PET and FDG. The possible limitations are inflammatory processes, which may obscure tumor detection because of the increased FDG uptake, as well as malignant lesions with low FDG uptake as a result of reduced perfusion. Comparison of tumor perfusion and FDG uptake showed a significant nonlinear correlation of r = 0.78 between the two parameters. Two patients with scar tissue and no evidence of malignancy were excluded from blood stem-cell support therapy as a result of the PET study. The data demonstrate that PET is a useful tool for making a diagnosis and deciding on therapy for malignant lymphomas.
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PMID:[Positron emission tomography (PET) in diagnosis and therapy planning of malignant lymphoma]. 915 79

Positron emission tomography (PET) is a whole-body imaging technique using 18 fluorine-fluorodeoxyglucose (FDG), whose uptake is increased in tumor cells. Published studies have shown PET to be an effective method of staging lymphoma and to be more sensitive than CT at detecting extranodal disease. The purpose of this study was to determine whether the increased marrow uptake of FDG observed in some lymphoma patients during routine staging PET scans represented marrow involvement by disease. PET scans of 50 patients with Hodgkin's (12) and non-Hodgkin's (38) lymphoma were analyzed by three independent observers and the marrow graded as normal or abnormal using a visual grading system. Unilateral iliac crest marrow aspirates and biopsies were performed on all patients. The PET scan and marrow histology agreed in 39 patients (78%), being concordant positive in 13 and concordant negative in 26 patients. In 8 patients the PET scan showed increased FDG uptake but staging biopsy was negative; in 4 of these 8 patients the PET scan showed a normal marrow background with focal FDG "hot spots" distant from the site biopsied. In 3 patients the marrow biopsy specimen was positive but the PET scan normal; 2 of these 3 patients had non-Hodgkin's lymphoma whose malignant cells did not take up FDG at lymph node or marrow disease sites. Therefore, there were only 5 patients (10%) in whom there was a difference between the PET scan and biopsy result which could not be fully explained. Visual interpretation of marrow FDG uptake during whole-body staging PET scans can correctly assess marrow disease status in a high proportion of lymphoma patients. PET has the potential to reduce the need for staging marrow biopsy.
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PMID:Detection of lymphoma in bone marrow by whole-body positron emission tomography. 955 91

Fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) has been shown to improve the diagnostic accuracy in the staging of malignant lymphomas, based on the metabolic signal of the lesions. This study was undertaken to determine the effect of attenuation correction in the detection of nodal and extranodal lesions in the primary staging of malignant lymphomas. Fifty-one untreated patients with either non-Hodgkin lymphoma (NHL, n=29) or Hodgkin's disease (n=22) were retrospectively evaluated. Static FDG-PET imaging of the trunk was performed following administration of 250-350 MBq FDG. Attenuation correction was performed in all patients. Images were reconstructed iteratively with or without transmission scans. Image evaluation was performed independently by two observers, who each examined one set of images (i.e. attenuation-corrected or uncorrected). The final decision as to whether results were discordant was reached by consensus of both observers. Out of 593 evaluated lymph node regions, 187 regions of increased FDG uptake were identified by both techniques. Differences between the readers concerned mainly the anatomical assignment of lesions (n=33) or the status (benign/malignant) of individual lesions (n=24). However, direct comparison of the two sets of images demonstrated very similar lesion contrast on attenuation-corrected and non-attenuation-corrected images. Real differences could be determined only in five regions (neck, 1; mediastinum, 1; upper abdomen, 3). Thirty-seven extranodal lesions (including lung, liver, spleen, bone marrow and soft tissue) were detected by both techniques without significant differences. It is concluded that in this study, attenuation correction did not improve the diagnostic accuracy of FDG-PET in the detection of lymph node or organ involvement during the primary staging of malignant lymphomas. Of more importance seemed to be the experience of the reader regarding the classification of a lesion's status the anatomical assignment, knowledge of physiological uptake and artefacts, and systematic and skillful examination of all regions scanned.
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PMID:Role of attenuation correction for fluorine-18 fluorodeoxyglucose positron emission tomography in the primary staging of malignant lymphoma. 993 59

A dilemma may occur in relation to patients with cervical metastases appearing as the first sign of malignancy in the head and neck region. In these patients, the location of the involved lymph nodes may indicate the location of the primary tumor. However, in two or three per cent of the patients, the primary tumor cannot be identified in the diagnostic workup. The aim of the present study was to investigate the possibility of identification of primary tumors in patients with cervical metastases of unknown origin, by the use of 2-(fluorine-18)fluoro-deoxy-D-glucose (FDG) dual-head positron emission tomography (PET). Ten consecutive patients with a cervical metastases of unknown origin were studied with FDG, using a dual-head PET camera. After the injection of 185 MBq (5 mCi) of FDG, images were performed of the head, neck and chest. In addition, endoscopy and biopsies were carried out with knowledge of the PET study. In patients in whom a primary tumor could not be identified, a follow-up of at least 6 months was used as a control. In five out of 10 patients a primary tumor was identified by FDG-PET. In one patient multiple sites of uptake were seen, and this was found to be consistent with non-Hodgkin lymphoma. In five patients, additional sites of increased uptake were found, these being consistent with unknown metastatic disease. Finally, in six patients, the initial treatment plan was changed due to the PET result in five of them. In one patient, the primary tumor was resected revealing a lesion with a diameter of 6 mm. The detection of FDG in patients with cervical metastases of unknown origin by the use of a dual-head PET camera is a valuable diagnostic tool in the identification of primary lesions.
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PMID:The detection of unknown primary tumors in patients with cervical metastases by dual-head positron emission tomography. 1064 4

FDG-Positron emission tomography (FDG-PET) is an imaging modality using the physiological tracer glucose [modified as 18-fluorine-2-fluorodeoxyglucose (FDG)], whose uptake and metabolism is increased in malignant cells. While exact tumor staging in lymphomatous diseases is the basis for choosing the appropriate treatment strategy, the detection of nodal and extranodal manifestations are a key prerequisite. This study demonstrates that FDG-PET is an efficient, non-invasive method for the staging of primary untreated Hodgkin's lymphoma (HD) and non-Hodgkin's lymphoma (NHL). Clinical PET scanning is very useful in staging lymphoma patients and is more accurate than computed tomography (CT) in detecting lesions.
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PMID:Positron emission tomography for detection and staging of malignant lymphoma. 1080 66

Positron emission tomography (PET) is the most powerful molecular imaging technique currently available for clinical use. Because deranged tumour metabolism is a common finding in many malignancies, PET is frequently used for tissue characterisation, staging and therapy control. Four previous consensus studies in Germany, performed up to 1997, have established indications for fluorine-18 fluoro-2-deoxy-D-glucose (FDG) PET in oncology, neurology and cardiology. More than 10,000 references on FDG-PET have been published in the meantime, mostly on oncological issues. Therefore, it was the aim of the present paper to provide an update on the clinical use of FDG-PET in oncology. For this purpose a systematic literature search was performed in all common medical literature databases. All hits were manually checked and abstracts, case reports, technically oriented papers and reviews were excluded from analysis. A questionnaire comprising 24 items was developed for standardised quality assessment according to evidence-based medicine (EBM) criteria. We selected 533 papers for further review by an interdisciplinary panel of 58 experts from oncology, radiology and nuclear medicine. Clinical use was judged according to the following grading scheme: 1a, established clinical use; 1b, clinical use probable; 2, useful in individual cases; 3, not yet assessable owing to missing or incomplete data; 4, clinical use rare (either as inferred from theoretical considerations or as demonstrated by published studies). Of the 533 papers selected, 122 references with 7,092 documented patients fulfilled the EBM criteria for detailed review. The results of these studies were tabulated and are available at www.nucmed-ulm.de. Clinical indications (grade 1a or 1b) were established for differentiating benign from malignant lesions in pulmonary nodules, pancreatic masses and residual masses after chemotherapy in malignant lymphoma. Staging was improved by FDG-PET in oesophageal cancer, breast cancer, head and neck cancer, lung cancer, malignant lymphoma and malignant melanoma. Effectiveness of radio- and/or chemotherapy could be better controlled in Hodgkin's disease and high-grade non-Hodgkin's lymphoma. Restaging was improved in relapsing thyroid cancer, colorectal cancer, head and neck cancer, lung cancer and malignant melanoma. In summary, the efficiency of FDG-PET was studied in several thousand patients with malignant tumours and was found to be well documented in the international high-quality peer-reviewed literature. There are clear-cut clinical indications for FDG-PET in diagnosis, staging and therapy control, and the technique can help to improve the management of many patients with cancer.
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PMID:FDG-PET for clinical use. Results of the 3rd German Interdisciplinary Consensus Conference, "Onko-PET III", 21 July and 19 September 2000. 1170 15

Fluorine-18fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) has become a very useful technique for the therapy monitoring of patients with lymphoma. It provides unique information about the metabolic behavior of the disease independent of morphological criteria. In recent years, [18F]FDG-PET has proven to be a technique with high sensitivity for the detection of residual tumor. Therefore, [18F]FDG-PET seems to be the ideal tool for the evaluation of treatment response. However, most recent published studies included both HD and NHL, although [18F]FDG-PET scan results in Hodgkin's disease (HD) has a different impact than in Non Hodgkin's Lymphoma (NHL). In this paper, we summarize our findings on the role of [18F]FDG-PET in the therapy evaluation of lymphoma patients in a large group of patients and highlight the differences between the interpretations of the results of HD and NHL patients. Finally, a strategy for the implementation of [18F]FDG-PET in the management of lymphoma patients is proposed.
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PMID:Evaluation of treatment response in patients with lymphoma using [18F]FDG-PET: differences between non-Hodgkin's lymphoma and Hodgkin's disease. 1178 19


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