Translational cancer research · 2025
Role of 18F-FDG PET/CT in the diagnosis and treatment response assessment of primary pulmonary lymphoma.
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Pu Yongzhu, Xie Ran, Li Kun, Zhang Chunhong, Zhao Sheng, Liu Xin, He Haicheng, Chen Ningning, Xiao Yuqiang, Hu Qiuyuan, Deng Zhiyong, Chen Long
Аннотация
BACKGROUND: Primary pulmonary lymphoma (PPL) is a rare form of primary pulmonary malignancy. The clinical significance of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in PPL remains underexplored. This study aimed to evaluate the diagnostic and therapeutic utility of 18F-FDG PET/CT in PPL.
METHODS: A total of 22 patients with PPL who underwent PET/CT examination before treatment were included in this study. Their clinicopathological parameters and PET/CT parameters were analyzed.
RESULTS: Twenty-two patients were retrospectively included, of whom 20 patients presented with respiratory symptoms. The most common imaging finding was consolidation; 40.9% of patients presented with one or more major CT signs divided into the mixed type. A total of 72.7% of the patients had associated CT signs, and air bronchograms were the most common symptom. The imaging findings did not significantly differ between mucosa-associated lymphoid tissue (MALT) lymphoma patients and non-MALT lymphoma patients. Diffuse large B-cell lymphoma (DLBCL) patients had the highest median maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), and total lesion glycolysis (TLG), whereas MALT lymphoma patients presented the highest metabolic tumor volume (MTV). Ten patients underwent posttreatment PET/CT evaluation, which revealed consistent results across the Deauville scale, ∆SUVmax, ∆MTV, and ∆TLG, with more than half of the patients remaining PET positive. After a median follow-up of 48.7 months, 2 patients had died. PPL presents distinct imaging features and metabolic characteristics across pathological subtypes. Although PPL generally has a favorable prognosis, its response to treatment is limited.
CONCLUSIONS: The various pathological types of PPLs differ in their metabolic characteristics. PPL has a good prognosis but is not sensitive to treatment. PET/CT is integral in the diagnosis, staging, and evaluation of treatment efficacy in PPL and should be considered in clinical decision-making.
METHODS: A total of 22 patients with PPL who underwent PET/CT examination before treatment were included in this study. Their clinicopathological parameters and PET/CT parameters were analyzed.
RESULTS: Twenty-two patients were retrospectively included, of whom 20 patients presented with respiratory symptoms. The most common imaging finding was consolidation; 40.9% of patients presented with one or more major CT signs divided into the mixed type. A total of 72.7% of the patients had associated CT signs, and air bronchograms were the most common symptom. The imaging findings did not significantly differ between mucosa-associated lymphoid tissue (MALT) lymphoma patients and non-MALT lymphoma patients. Diffuse large B-cell lymphoma (DLBCL) patients had the highest median maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), and total lesion glycolysis (TLG), whereas MALT lymphoma patients presented the highest metabolic tumor volume (MTV). Ten patients underwent posttreatment PET/CT evaluation, which revealed consistent results across the Deauville scale, ∆SUVmax, ∆MTV, and ∆TLG, with more than half of the patients remaining PET positive. After a median follow-up of 48.7 months, 2 patients had died. PPL presents distinct imaging features and metabolic characteristics across pathological subtypes. Although PPL generally has a favorable prognosis, its response to treatment is limited.
CONCLUSIONS: The various pathological types of PPLs differ in their metabolic characteristics. PPL has a good prognosis but is not sensitive to treatment. PET/CT is integral in the diagnosis, staging, and evaluation of treatment efficacy in PPL and should be considered in clinical decision-making.