Journal of Nuclear Medicine Radiology & Radiation Therapy Category: Medical Type: Editorial
18F-FDG-PET/CT Imaging in Leukemia
- Manas Kumar Sahoo1*, Smeeta Gajendra2
- 1 Department Of Nuclear Medicine, All India Institute Of Medical Sciences (AIIMS), New Delhi-110029, India
- 2 Department Of Pathology And Laboratory Medicine, Medanta-The Medicity, Sector - 38, Gurgaon, Haryana, India
*Corresponding Author:Manas Kumar Sahoo
Department Of Nuclear Medicine, All India Institute Of Medical Sciences (AIIMS), New Delhi-110029, India
Received Date: Apr 25, 2016 Accepted Date: Apr 29, 2016 Published Date: May 14, 2016
Leukemia’s are characterized by diffuse replacement of bone marrow with proliferating leukemic cells with circulating immature white blood cells in the blood and widespread infiltrates in the liver, spleen, lymph nodes and other sites throughout the body. Leukemia’s are classified as acute or chronic and lymphoid or myeloid.
PET/CT IN ACUTE LEUKEMIA
PET/CT IN CHRONIC LEUKEMIA
There are few limitations of 18F- FDG PET-CT. FDG is not a very tumor-specific substance, in as much as the leukocytes and macrophages of inflammatory processes also accumulate the tracer which is a major source of false-positive diagnoses in the application of FDG-PET in oncology. Diffuse bone marrow uptake in FDG PET/CT may be due to an inflammatory reaction, recent chemotherapy or administration of hematopoietic growth factors/ colony stimulating factor. To reduce the potentially negative impact of occasional false-positive FDG-PET results on patient management, it is absolutely mandatory to carefully select the candidates for an FDG-PET scan to wait 8-10 weeks after surgery,10-12 weeks after local RT and 4-6 weeks after chemotherapy before an FDG PET scan is done.
To conclude, FDG PET/CT is useful in diagnosis and follow-up of patients with bone marrow malignancy.18F-FDG PET/CT may be useful for guiding the site of BM aspiration in cases with localized bone marrow involvement. It has an important role in diagnosing extra-medullary disease in de novo or relapsed AML patients. It can guide a diagnostic biopsy and may also provide prognostic information in patients with CLL. It is also useful in detection of Richter's transformation in CLL cases. Possibility of leukemia in known case of solid malignancies also kept in mind in follow up cases in which diffuse marrow uptake may be misinterpreted as chemotherapy effect or bone marrow metastasis by solid tumors. Bone marrow aspiration/biopsy must be performed for correct diagnosis and early management.
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Citation: Sahoo MK, Gajendra S (2016) 18 F-FDG-PET/CT Imaging in Leukemia. J Nucl Med Radiol Radiat Ther 1: 003.
Copyright: © 2016 Manas Kumar Sahoo, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.