Efficacy of routine surveillance with positron emission tomography/computed tomography in aggressive non-Hodgkin lymphoma in complete remission: status in a single center

Post-therapy surveillance imaging in patients with lymphoma remains controversial. We report our experience with positron emission tomography/computed tomography (PET/CT) surveillance in patients with aggressive non-Hodgkin lymphoma in first complete remission (CR). The 138 PET/CTs performed in 52 p...

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Published inLeukemia & lymphoma Vol. 52; no. 4; pp. 597 - 603
Main Authors El-Galaly, Tarec, Prakash, Vineet, Christiansen, Ilse, Madsen, Jakob, Johansen, Preben, Boegsted, Martin, Johnsen, Hans-Erik, Bukh, Anne
Format Journal Article
LanguageEnglish
Published United States Informa Healthcare 01.04.2011
Taylor & Francis
Subjects
Adult
Aged
cost-effectiveness
Female
follow-up
Humans
Lymphoma, Non-Hodgkin - diagnostic imaging
Lymphoma, Non-Hodgkin - pathology
Lymphoma, Non-Hodgkin - therapy
Male
Middle Aged
Neoplasm Staging
Non-Hodgkin lymphoma
PET/CT
positron emission tomography
Positron-Emission Tomography - economics
relapse
Remission Induction
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed - economics
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Summary:Post-therapy surveillance imaging in patients with lymphoma remains controversial. We report our experience with positron emission tomography/computed tomography (PET/CT) surveillance in patients with aggressive non-Hodgkin lymphoma in first complete remission (CR). The 138 PET/CTs performed in 52 patients revealed four unsuspected relapses. In one patient, relapse was visualized by fluorodeoxyglucose (FDG) accumulation without any significant CT pathology. The specificity and sensitivity of surveillance PET/CT were 89% and 100%, respectively. The predictive values of positive and negative PET/CTs were 21% and 100%, respectively. The cost of half-yearly routine PET/CT surveillance during the first 2 years in CR was $US8552 per patient and accounted for 81% of the total follow-up costs. PET/CT was effective in detecting unexpected relapse and normal PET/CT supported continuous CR. However, the impact of PET/CT was limited by the high number of false-positive results and PET/CT surveillance was costly compared to CT surveillance.
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ISSN:1042-8194
1029-2403
DOI:10.3109/10428194.2010.547642