Findings of 18F-Fluorodeoxyglucose Positron-Emission Tomography in Methotrexate-Related Lymphoproliferative Disorder
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Author(s)
1Department of Radiology, Kobe University Hospital, Kobe, Japan.
2Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
3Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
4Department of Diagnostic Pathology, Kobe University Hospital, Kobe, Japan.
2Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
3Division of Medical Oncology/Hematology, Department of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
4Department of Diagnostic Pathology, Kobe University Hospital, Kobe, Japan.
Introduction: The use of methotrexate (MTX) for
rheumatoid arthritis (RA) is increasing. However, the immune suppression
state leads to the occurrence of lymphoproliferative disorder
(MTX-LPD). The purpose of this study was to describe the findings of
18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in
MTX-LPD patients, and compare it with non-MTX-related malignant lymphoma
(ML). Materials and Methods: We retrospectively reviewed 11 MTX-LPD
patients (9 female, mean age 68.3 years) and 21 ML patients (7 female,
mean age 60.6 years) with a histopathological diagnosis. FDG-PET imaging
was performed using a standard oncology procedure. We assessed the
disease distribution based on FDG-PET images and measured the maximum
standardized up take values (SUVmax) for each region. Results: Mean
values of SUVmax in MTX-LPD and ML were 14.6 and 17.2, respectively (p =
0.49). In MTX-LPD, 55 lesions met the Cotswold classification,
consisting of 37 nodal and 18 extranodal lesions. In ML, 82 lesions were
found, consisting of 68 nodal and 14 extranodal lesions. MTX-LPD showed
a higher incident of the involvement in extranodal lesions throughout
the whole body (p < 0.001). Conclusion: Because this disease occurs
widely throughout the whole body, we need to pay attention to the less
frequent sites as well when performing PET imaging in patients with
MTX-LPD.
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Cite this paper
Kono, A. , Kitajima, K. , Mmatsuoka, H. , Otani, K. , Itoh, T. and Sugimura, K. (2014) Findings of 18F-Fluorodeoxyglucose Positron-Emission Tomography in Methotrexate-Related Lymphoproliferative Disorder. Open Journal of Radiology, 4, 293-300. doi: 10.4236/ojrad.2014.44038.
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