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Neuro-Oncology 2008 10(2):223-228; doi:10.1215/15228517-2007-061
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Society for Neuro-Oncology

The utility of body FDG PET in staging primary central nervous system lymphoma

Nimish A. Mohile, Lisa M. DeAngelis and Lauren E. Abrey

Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA

Address correspondence to Lauren E. Abrey, 1275 York Avenue, Department of Neurology, New York, NY 10021, USA (abreyl{at}mskcc.org).


  Abstract

18F-Fluorodeoxyglucose (FDG) PET has become an important tool in the management of non-Hodgkin's lymphoma (NHL), but its role in the evaluation of primary CNS lymphoma (PCNSL) has not been established. We investigated the ability of body FDG PET to detect systemic disease in the staging and restaging of PCNSL. The records of 166 PCNSL patients seen at Memorial Sloan-Kettering Cancer Center were examined. Forty-nine patients who underwent body FDG PET for staging of PCNSL were identified. Clinical data were reviewed to determine FDG PET results and their influence on therapy. Body FDG PET disclosed a systemic site of malignancy in 15% of patients. NHL was found in 11% of all patients, 7% of patients at diagnosis, and 27% of patients at CNS relapse. Four percent had a second systemic neoplasm. Workup with conventional staging did not reveal systemic disease, and in 8% of patients, body FDG PET was the only abnormal diagnostic exam suggestive of lymphoma. FDG PET findings altered patient treatment and resulted in additional chemotherapy, surgery, or radiotherapy. Our findings suggest that FDG PET may be more sensitive than conventional body staging and may disclose higher rates of concomitant systemic disease at PCNSL diagnosis. Body FDG PET may be an important noninvasive adjunct to conventional PCNSL staging, and its utility should be evaluated prospectively.

Keywords: FDG PET, primary CNS lymphoma

Received June 11, 2007; Accepted July 11, 2007


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