FDG‐PET/CT‐guided rebiopsy may find clinically unsuspicious transformation of follicular lymphoma

Abstract

Aim The purpose of the study was to evaluate the clinical impact of fluorodeoxyglucose‐positron emission tomography/computed tomography (FDG‐PET/CT) followed by a new biopsy from the site with maximum standardized uptake value (SUVmax) in case of high maximal SUV values, in detecting clinically unsuspected histologic transformations (HT) of follicular lymphoma (FL). Methods This retrospective study included all the patients who had undergone FDG‐PET/CT during primary diagnosis or relapse of FL between 2010 and 2020 at Oulu University Hospital. Results The diagnosis changed from an indolent disease to a transformed lymphoma in >10% (7/63) of the patients who underwent diagnostic FDG‐PET/CT. The HT risk associated with high SUVmax (>10) was 24% (7 of 29 performed biopsies). Four out of these seven patients with verified HT had no previous clinical suspicion of transformation. Conclusion Our results suggest that a rebiopsy based on a high SUVmax in diagnostic FDG‐PET/CT is valuable in detecting clinically unsuspected HT of FL.

Keywords

• FDG‐PET/CT
• follicular lymphoma
• histologic transformation
• indolent lymphoma
• SUVmax