Diagnostic value of 18F-FDG PET/CT for cutaneous extranodal natural killer/T-cell lymphoma, nasal type

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Abstract

Objective

To evaluate the use of fluorine-18 fluorodeoxyglucose (18F-FDG) PET/computed tomography (CT) in the diagnosis of cutaneous extranodal natural killer/T-cell lymphoma, nasal type (C-ENK/T-NT).

Methods

A total of 39 patients with newly diagnosed C-ENK/T-NT were enrolled between May 2006 and November 2013. Anatomic regions (n=429; five cutaneous and six extracutaneous regions per patient) were assessed using an 18F-FDG PET/CT scan and conventional staging methods (CSMs). 18F-FDG PET/CT and CSMs were compared and evaluated for their ability to detect tumor lesions and their influence on the staging and treatment strategies. Biopsy and clinical follow-up were used as the gold standard for diagnosis.

Results

In total, 139 lesions were detected by CSMs and 18F-FDG PET/CT, of which there were 50 cutaneous and 89 extracutaneous-positive regions. 18F-FDG PET/CT detected 48 cutaneous and 88 extracutaneous regions. CSMs, however, detected only 34 cutaneous lesions and 61 extracutaneous lesions that were positive for malignancy (cutaneous comparison of PET/CT vs. CSMs, P<0.001; extracutaneous comparison of PET/CT vs. CSMs, P<0.05). Using 18F-FDG PET/CT, 8 (42%) patients were in stage I–II and 31 patients (58%) were in stage III–IV. 18F-FDG PET/CT staging was consistent with the final stage determination in 94.9% (37/39) of patients, whereas CSMs staging was correct in final stage determination in 74.4% (29/39) of patients (P=0.025).

Conclusion

Our study showed that 18F-FDG PET/CT scanning is a valuable modality for the detection of cutaneous and extracutaneous lesions of C-ENK/T-NT. 18F-FDG PET/CT may therefore influence future staging and treatment strategies.

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