FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease

Fabio M. Paes, Dimitrios G. Kalkanis, Panagiotis A. Sideras, Aldo N Serafini

Research output: Contribution to journalArticle

157 Citations (Scopus)

Abstract

The term extranodal disease refers to lymphomatous infiltration of anatomic sites other than the lymph nodes. Almost any organ can be affected by lymphoma, with the most common extranodal sites of involvement being the stomach, spleen, Waldeyer ring, central nervous system, lung, bone, and skin. The prevalence of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease has increased in the past decade. The imaging characteristics of extranodal involvement can be subtle or absent at conventional computed tomography (CT). Imaging of tumor metabolism with 2-[fluorine-18]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) has facilitated the identification of affected extranodal sites, even when CT has demonstrated no lesions. More recently, hybrid PET/CT has become the standard imaging modality for initial staging, follow-up, and treatment response assessment in patients with lymphoma and has proved superior to CT in these settings. Certain PET/CT patterns are suggestive of extranodal disease and can help differentiate tumor from normal physiologic FDG activity, particularly in the mucosal tissues, bone marrow, and organs of the gastrointestinal tract. Familiarity with the different extranodal manifestations in various locations is critical for correct image interpretation. In addition, a knowledge of the differences in FDG avidity among the histologic subtypes of lymphoma, appropriate timing of scanning after therapeutic interventions, and use of techniques to prevent brown fat uptake are essential for providing the oncologist with accurate information.

Original languageEnglish
Pages (from-to)269-291
Number of pages23
JournalRadiographics
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2010

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Fluorine
Hodgkin Disease
Non-Hodgkin's Lymphoma
Lymphoma
Tomography
Glucose
Brown Adipose Tissue
Therapeutic Uses
Positron-Emission Tomography
Gastrointestinal Tract
Neoplasms
Stomach
Mucous Membrane
Spleen
Central Nervous System
Lymph Nodes
Bone Marrow
Bone and Bones
Lung
Skin

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease. / Paes, Fabio M.; Kalkanis, Dimitrios G.; Sideras, Panagiotis A.; Serafini, Aldo N.

In: Radiographics, Vol. 30, No. 1, 01.01.2010, p. 269-291.

Research output: Contribution to journalArticle

Paes, Fabio M. ; Kalkanis, Dimitrios G. ; Sideras, Panagiotis A. ; Serafini, Aldo N. / FDG PET/CT of extranodal involvement in non-Hodgkin lymphoma and Hodgkin disease. In: Radiographics. 2010 ; Vol. 30, No. 1. pp. 269-291.
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