Al Khawtani, R.H.M. (Rayan) (2018) LDH levels and FDG-PET/CT metrics differentiate between mediastinal Hodgkin lymphoma and primary mediastinal B-cell lymphoma. thesis, Medicine.
Full text available on request.Abstract
Lymphomas are cancers that originate from lymphoid tissue (either lymph nodes or extranodal lymphatic tissue). This research focused on Hodgkin lymphoma and primary mediastinal B-cell lymphoma (PMBCL), the latter which is a rather uncommon type of non-Hodgkin lymphoma. Hodgkin lymphoma and PMBCL have in common that they both can present with a mediastinal mass (in fact, PMBCL by definition involves the mediastinum) and, as such, can mimic each other. Pathological examination is necessary to establish the diagnosis, but biopsy in the mediastinum may be difficult and is not without risks. Hence, it may be valuable to have additional non-invasive methods to discriminate there two entities. The aim of this research was to investigate if clinical, laboratory, and 18F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) findings can discriminate between mediastinal Hodgkin lymphoma and PMBCL. An analysis in 42 patients with mediastinal Hodgkin lymphoma and 14 patients with PBMCL showed that lactate dehydrogenase (LDH) and FDG-PET/CT-based maximum tumor diameter, lesion-to-liver ratio SUVmax, and lesion-to-liver ratio SUVpeak were all significantly higher in PMBCL than in Hodgkin lymphoma (P=0.000), and PMBCL also significantly more frequently (P=0.0001) exhibited necrosis on FDG-PET/CT than Hodgkin lymphoma. LDH, maximum tumor diameter, lesion-to-liver ratio SUVmax, and lesion-to-liver ratio SUVpeak yielded areas under the receiver operating characteristic curve of 0.968, 0.857, 0.869, and 0.881, respectively. Age, gender, hemoglobine, leukocytes, C-reactive protein, Ann Arbor stage, and presence of tumor calcifications were not significantly different between Hodgkin lymphoma and PMBCL (P=0.268 to 0.999). Based on these data, it can be concluded that LDH levels and several FDG-PET/CT metrics (tumor size, presence of tumor necrosis, and degree of FDG uptake) are valuable in discriminating mediastinal Hodgkin lymphoma from PMBCL.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Kwee, Thomas C. MD PhD and Location of research: and University Medical Center Groningen, Medical Imaging Center |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:40 |
| Last Modified: | 25 Jun 2020 10:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/134 |
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