Utility of 18-fluorodeoxyglucose positron emission tomography in children with relapsed/refractory leukemia

Kaya Z., Akdemir O. U., Atay O. L., Akyürek N., Pınarlı F. G., Yenicesu I., ...More

PEDIATRIC HEMATOLOGY AND ONCOLOGY, vol.35, pp.393-406, 2018 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 35
  • Publication Date: 2018
  • Doi Number: 10.1080/08880018.2018.1557306
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.393-406
  • Keywords: 18-Fluorodeoxyglucose positron emission tomography, acute lymphoblastic leukemia, acute myeloid leukemia, ACUTE MYELOID-LEUKEMIA, STEM-CELL TRANSPLANTATION, BONE-MARROW BIOPSY, FDG-PET/CT, HODGKIN LYMPHOMA, RELAPSE, T(8/21), DISEASE
  • Gazi University Affiliated: Yes


Objective: Few data are available on the clinical significance of 18-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) results in patients with leukemia. We investigated the utility of FDG-PET/CT at the time of relapsed/refractory disease in pediatric patients with leukemia. Methods: Medical records of 28 children with suspected leukemia progression or recurrence during/after chemotherapy or allogeneic stem cell transplantation (allo-SCT) were retrospectively reviewed to determine the utility of FDG-PET/CT. Results: Twenty-two of the 28 patients have documented abnormal imaging findings during clinical follow-up, while six had were interpreted as not demonstrating signal consistent with active leukemia. Of the 22 patients with abnormal FDG-PET/CT studies 14 were found to have FDG-PET/CT reported as consistent with active leukemia and increased leukemia blasts on bone marrow biopsy. Regarding the eight patients without positive FDG-PET/CT and proven leukemia relapse, four had discordant findings on FDG-PET/CT and biopsy, and four had FDG-PET/CT reported as infection. Mean maximum standardized uptake values (SUVmax) were significantly higher among patients whose FDG-PET/CT findings were positive for leukemia as opposed to infectious disease (p < .05). Mean SUVmax was also significantly higher among patients with multifocal lesions on FDG-PET/CT than among those with diffuse lesions (p < .05). Conclusions: The findings suggest that FDG-PET/CT may be a complementary imaging modality that could be combined with bone marrow examination to improve detection of subtle leukemic infiltration in children with suspected leukemia progression or recurrence after chemotherapy or allo-SCT.