Factors affecting intrapatient liver and mediastinal blood pool 18F-FDG standardized uptake value changes during ABVD chemotherapy in Hodgkin's lymphoma

Agostino Chiaravalloti, Roberta Danieli, Paolo Abbatiello, Barbara Di Pietro, Laura Travascio, Maria Cantonetti, Manlio Guazzaroni, Antonio Orlacchio, Giovanni Simonetti, Orazio Schillaci

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Purpose: The aim of our study was to assess the intrapatient variability of 2-deoxy-2-(18F)-fluoro-D-glucose (18F-FDG) uptake in the liver and in the mediastinum among patients with Hodgkin's lymphoma (HL) treated with doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine (ABVD) chemotherapy (CHT). Methods: The study included 68 patients (30 men, 38 women; mean age 32±11 years) with biopsy-proven HL. According to Ann Arbor criteria, 6 were stage I, 34 were stage II, 12 were stage 3 and 16 were stage 4. All of them underwent a baseline (PET0) and an interim (PET2) 18F-FDG whole-body positron emission tomography (PET)/CT. All patients were treated after PET0 with two ABVD cycles for 2 months that ended 15±5 days prior to the PET2 examination. All patients were further evaluated 15±6 days after four additional ABVD cycles (PET6). None of the patients presented a serum glucose level higher than 107 mg/dl. The mean and maximum standardized uptake values (SUV) of the liver and mediastinum were calculated using the same standard protocol for PET0, PET2 and PET6, respectively. Data were examined by means of the Wilcoxon matched pairs test and linear regression analysis. Results: The main results of our study were an increased liver SUVmean in PET2 (1.76±0.35) as compared with that of PET0 (1.57±0.31; pmax in PET2 (3.13±0.67) as compared with that of PET0 (2.82±0.64; pmean and SUVmax in PET0, PET2 and PET6 (p>0.05). Another finding is a relationship in PET0 between liver SUVmean and SUVmax with the stage, which was lower in those patients with advanced disease (r 2=0.1456 and p=0.0013 for SUVmean and r 2=0.1277 and p=0.0028 for SUVmax). Conclusion: The results of our study suggest that liver 18F-FDG uptake is variable in patients with HL during the CHT treatment and the disease course and should be considered carefully when used to define the response to therapy in the interim PET in HL.

Original languageEnglish
Pages (from-to)1123-1132
Number of pages10
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Issue number6
Publication statusPublished - 2014


  • ABVD
  • Chemotherapy
  • Deauville score
  • FDG
  • Hodgkin's lymphoma
  • Lymphoma
  • PET

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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