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Background: The purpose of this study was to evaluate the impact of 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography (FDG-PET/CT) during follow-up of patients with diffuse large B-cell lymphoma (DLBCL) being in complete remission or unconfirmed complete remission after first-line therapy. Patients and methods: DLBCL patients receiving FDG-PET/CT during follow-up were analyzed retrospectively. Confirmatory biopsy was mandatory in cases of suspected disease recurrence. Results: Seventy-five patients were analyzed and 23 (30%) had disease recurrence. The positive predictive value (PPV) of FDG-PET/CT was 0.85. Patients >60 years [P = 0.036, hazard ratio (HR) = 3.82, 95% confidence interval (CI) 1.02-7.77] and patients with symptoms indicative of a relapse (P = 0.015; HR = 4.1; 95% CI 1.20-14.03) had a significantly higher risk for relapse. A risk score on the basis of signs of relapse, age >60 years, or a combination of these factors identified patients at high risk for recurrence (P = 0.041). Conclusions: FDG-PET/CT detects recurrent DLBCL after first-line therapy with high PPV. However, it should not be used routinely and if only in selected high-risk patients to reduce radiation burden and costs. On the basis of our retrospective data, FDG-PET/CT during follow-up is indicated for patients 60 years with and without clinical signs of relapse

The purpose of the study was to evaluate the impact of 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/computed tomography (CT) during follow-up of patients with Hodgkin's lymphoma.Patients in complete remission or an unconfirmed complete remission after first-line therapy who received FDG-PET/CT during their follow-up were analyzed retrospectively. Confirmatory biopsy was mandatory in case of recurrence.Overall, 134 patients were analyzed. Forty-two (31.3%) patients had a recurrence. The positive predictive value of FDG-PET/CT was 0.98. Single-factor analysis identified morphological residual mass [P = 0.0005, hazard ratio (HR) 3.4, 95% confidence interval (CI) 1.7-6.6] and symptoms (P0.0001, HR 4.9, 95% CI 2.4-9.9) as significant risk factors for relapse. By multivariate analysis, morphological residual mass was the only significant risk factor for early follow-up (24 months) (P = 0.0019, HR 7.6, 95% CI 2.1-27.3). Advanced stage (P = 0.0426, HR 3.6, 95% CI 1.1-12.3) and the presence of symptoms (P = 0.0009, HR = 14.6, 95% CI 3.0-69.7) were found to be significant risk factors for later follow-up (24 months).Asymptomatic patients without morphological residues and an early stage of disease do not need a routine FDG-PET/CT for follow-up. Asymptomatic patients with morphological residues should receive routine follow-up FDG-PET/CT for the first 24 months. Only patients with advanced initial stage do need a routine follow-up FDG-PET/CT beyond 24 months.

Background: The aim of this study was to evaluate the necessity of 2-[fluorine-18]fluoro-2-deoxy- D -glucose–positron emission tomography/computed tomography (FDG–PET/CT) after end of treatment in lymphoma patients who had an interim FDG–PET/CT. Patients and methods: In 38 patients with Hodgkin's disease (HD) and 30 patients with non-Hodgkin's lymphoma (NHL) interim PET/CT (intPET) after two to four cycles of chemotherapy and PET/CT after completion of first-line treatment (endPET) were carried out. Cost reduction was retrospectively calculated for the potentially superfluous endPET examinations. Results: In 31 (82%) HD patients, intPET demonstrated complete remission (CR) which was still present on endPET. The remaining seven HD patients (18%) had partial remission (PR) on intPET. For NHL, 22 (73%) patients had CR on intPET analysis which was still present on endPET. In the remaining eight NHL patients, intPET revealed PR in seven and stable disease in one patient. None of all intPET complete responders progressed until the end of therapy. Thus, of the 196 PET/CT's carried out in our study population, 53 endPET's (27.0%) were carried out in interim complete responders. Conclusion: End-treatment PET/CT is unnecessary if intPET shows CR and the clinical course is uncomplicated. An imaging cost reduction of 27% in our study population could have been achieved by omitting end of treatment FDG–PET/CT in interim complete responders.