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Inicio Medicina Clínica (English Edition) Evaluation of diffuse large B-cell lymphoma patients with 64-slice multidetector...
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Vol. 151. Issue 7.
Pages 255-264 (October 2018)
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Vol. 151. Issue 7.
Pages 255-264 (October 2018)
Original article
Evaluation of diffuse large B-cell lymphoma patients with 64-slice multidetector computed tomography versus 18FDG positron emission tomography/computed tomography in initial staging and restaging after treatment
Evaluación de la estadificación inicial y la respuesta final al tratamiento de los pacientes con linfoma difuso de célula grande B con la tomografía computarizada de 64 detectores frente a la 18FDG tomografía por emisión de positrones/tomografía computarizada
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Nieves Gómez Leóna,b, Gema Vegaa,c, Beatriz Rodríguez-Vigil Juncod,
Corresponding author
beatrizrodriguezvigil@yahoo.es

Corresponding author.
, Carlos Suevos Ballesterosa,b
a Instituto de Investigación, Servicio de Radiología del Hospital Universitario de la Princesa, Madrid, Spain
b Universidad Autónoma de Madrid, Madrid, Spain
c Servicio de Medicina Intensiva del Universitario de la Princesa, Madrid, Spain
d Osatek RM. Hospital Universitario de Álava, Vitoria, Spain
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Tables (3)
Table 1. Comparability between groups.
Table 2. Results in the initial staging and final response with 64MDCT and 18FDG PET/CT compared with the reference standard.
Table 3. Results of extranodal and bone marrow involvement with 64MDCT and 18FDG PET/CT compared with the reference standard.
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Abstract
Background and objectives

To prospectively compare the accuracy in initial staging and end-of-treatment restaging of diffuse large B-cell lymphoma (DLBCL) between 64-slice multidetector computed tomography (64MDCT) and 18FDG positron emission tomography/computed tomography (18FGD PET/CT) with intravenous contrast injection.

Material and methods

Randomized and blind controlled clinical multicentric trial that included biopsy-proven DLBCL patients. Seventy-two patients from five different hospitals in the region of Madrid, Spain, were enrolled in the study between January 2012 and June 2015. Thirty-six were randomly allocated to 18FDG PET/TC and the other 36–64MDCT for initial staging and end-of-treatment restaging. A nuclear medicine physician and a radiologist independently analyzed 18FDG PET/TC images and reached an agreement post hoc. 64MDCT images were separately evaluated by a different radiologist. Every set of images was compared to the reference standard that included clinical data, complementary tests and follow-up. The study was approved by participating centres’ ethics committees and written informed consent was obtained from all the participants.

Results

A good agreement was observed between both diagnostic techniques and the reference standard in initial staging [18FDG PET/CT (k=0.5) and 64MDCT (k=0.6)], although only the 18FDG PET/TC showed a good agreement with the reference standard for the end-of-treatment restaging (k=0.7).

Conclusion

In DLBCL, both 18FDG PET/TC and 64MDCT have shown good agreement with the reference standard in initial staging. Nevertheless, 18FDG PET/CT has shown to be superior to 64MDCT in end-of-treatment response assessment.

Keywords:
FDG-PET/CT
CT
Lymphoma
Non-Hodgkin's lymphoma
Resumen
Fundamento y objetivos

Comparar prospectivamente la exactitud diagnóstica de la tomografía computarizada de 64 detectores (TCMD64) y la tomografía por emisión de positrones/tomografía computarizada (18FDG PET/TC) con contraste intravenoso en pacientes con linfoma difuso de células grandes B (LDCGB) en la estadificación inicial y en la evaluación de la respuesta al final del tratamiento.

Material y métodos

Ensayo clínico controlado multicéntrico que incluyó 72 pacientes de 5 hospitales de la Comunidad de Madrid entre enero de 2012 y junio de 2015, aleatorizados de forma ciega a una diferente prueba de imagen inicial y final, 36 a 18FDG PET/TC y 36 a TCMD64. Un médico nuclear y un radiólogo interpretaron la 18FDG PET/TC de manera independiente, llegando a un consenso post hoc. Por otro lado, un radiólogo ajeno interpretó la TCMD64 por separado. El patrón de referencia incluyó datos clínicos, pruebas complementarias y seguimiento. El Comité Ético de cada hospital aprobó el estudio y los sujetos firmaron su consentimiento por escrito.

Resultados

Se observó buena concordancia de ambas pruebas diagnósticas con el patrón de referencia en la estadificación inicial (18FDG PET/CT [k=0,5] y TCMD64 [k=0,6]), existiendo solo buena concordancia en la evaluación de la respuesta al final del tratamiento con la 18FDG PET/TC (k=0,7).

Conclusión

En la estadificación inicial de pacientes con LDCGB existe un grado de acuerdo satisfactorio de la 18FDG PET/TC y la TCMD64 con el patrón de referencia, mientras que en la evaluación de la respuesta al final del tratamiento la 18FDG PET/TC es superior a la TCMD64.

Palabras clave:
FDG-PET/TC
TC
Linfoma
Linfoma no Hodgkin

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