scholarly journals Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

2020 ◽  
Author(s):  
Tomoya Ogawa ◽  
Nobuyuki Kawai ◽  
Keisuke Miyake ◽  
Aya Shinomiya ◽  
Yuka Yamamoto ◽  
...  
Keyword(s):  
Who Classification ◽  
World Health ◽  
Histopathological Diagnosis ◽  
Newly Diagnosed ◽  
Mutation Status ◽  
Flt Pet ◽  
Molecular Features ◽  
Pet Ct ◽  
The Mean ◽  
Met Pet

Abstract Background :The molecular features of isocitrate dehydrogenase (IDH) mutation and chromosome 1p and 19q (1p/19q) codeletion status have pivotal role for differentiating gliomas and have been integrated in the World Health Organization (WHO) classification in 2016. Positron emission tomography (PET) with 3’-Deoxy-3’-[18F]fluorothymidine (FLT) has been used to evaluate tumour grade and proliferative activity and compared with L-[methyl-11C]-methionine (MET) in glioma patients. Herein, we evaluated tracer uptakes of MET-PET/CT and FLT-PET/CT for differentiating glioma based on the 2016 WHO classification especially in relation to IDH1 mutation status.Methods : In total, 81 patients with newly diagnosed supratentorial glioma were enrolled in this study. They underwent PET/CT studies with MET and FLT before surgery. The molecular features and histopathological diagnosis based on the 2016 WHO classification were determined using surgical specimens. The ratios of the maximum standardized uptake value (SUV) of the tumours to the mean SUV of the contralateral cortex (T/N ratios) were calculated on MET-PET/CT and FLT-PET/CT images. Results : The mean T/N ratios of MET-PET/CT and FLT-PET/CT in IDH1-wildtype tumours were significantly higher than those in IDH1-mutant tumours (P<0.001 and P<0.001, respectively). Receiver operating characteristic analysis for differentiating IDH1 mutation status showed that the area under the curve of the FLT T/N ratio was significantly larger than that of the MET T/N ratio (P<0.01). The mean T/N ratio of FLT-PET/CT in IDH1-wildtype tumours was significantly higher than that in IDH1-mutant tumours among grade Ⅱ and Ⅲ gliomas (P=0.005), but this was not the case for MET-PET/CT. Both MET-PET/CT and FLT-PET/CT were able to distinguish between grade Ⅱ and Ⅲ gliomas in IDH1-mutant tumours (P=0.002 and P<0.001, respectively), but only FLT-PET/CT was able to distinguish between grade Ⅲ and Ⅳ gliomas in IDH1-wildtype tumours (P=0.029).Conclusion :This study showed that FLT-PET/CT can be used to determine the IDH1 mutation status and evaluate glioma grade more accurately than MET-PET/CT. FLT-PET/CT can improve glioma differentiation based on the 2016 WHO classification, but caution must be paid for tumours without contrast enhancement and further studies should be conducted with more cases.

scholarly journals Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

2020 ◽  
Author(s):  
Tomoya Ogawa ◽  
Nobuyuki Kawai ◽  
Keisuke Miyake ◽  
Aya Shinomiya ◽  
Yuka Yamamoto ◽  
...  
Keyword(s):  
Who Classification ◽  
World Health ◽  
Histopathological Diagnosis ◽  
Newly Diagnosed ◽  
Mutation Status ◽  
Flt Pet ◽  
Molecular Features ◽  
Pet Ct ◽  
The Mean ◽  
Met Pet

Abstract Background The molecular features of isocitrate dehydrogenase (IDH) mutation and chromosome 1p and 19q (1p/19q) codeletion status have pivotal role for differentiating gliomas and have been integrated in the World Health Organization (WHO) classification in 2006. Positron emission tomography (PET) with 18F-fluorothymidine (FLT) has been shown to evaluate tumour grade and proliferative activity more accurately than L-methyl-11C-methionine (MET) in glioma patients. Herein, we compared tracer uptakes of MET-PET/CT and FLT-PET/CT for differentiating glioma according to the 2016 WHO classification especially in relation to IDH1 mutation status.Methods In total, 81 patients with newly diagnosed supratentorial glioma were enrolled in this study. They underwent PET/CT studies with MET and FLT before surgery. The molecular features and histopathological diagnosis based on the 2016 WHO classification were determined using surgical specimens. The ratios of the maximum standardized uptake value (SUV) of the tumours to the mean SUV of the contralateral cortex (T/N ratios) were calculated on MET-PET/CT and FLT-PET/CT images. Results The mean T/N ratios of MET-PET/CT and FLT-PET/CT in IDH1-wildtype tumours were significantly higher than those in IDH1-mutant tumours (P<0.001 and P<0.001, respectively). Receiver operating characteristic analysis for differentiating IDH1 mutation status showed that the area under the curve of the FLT T/N ratio was significantly larger than that of the MET T/N ratio (P<0.01). The mean T/N ratio of FLT-PET/CT in IDH1-wildtype tumours was significantly higher than that in IDH1-mutant tumours among grade Ⅱ and Ⅲ gliomas (P=0.005), but this was not the case for MET-PET/CT. Both MET-PET/CT and FLT-PET/CT were able to distinguish between grade Ⅱ and Ⅲ gliomas in IDH1-mutant tumours (P=0.002 and P<0.001, respectively), but only FLT-PET/CT was able to distinguish between grade Ⅲ and Ⅳ gliomas in IDH1-wildtype tumours (P=0.029).Conclusion This study showed that FLT-PET/CT can be used to determine the IDH1 mutation status and evaluate glioma grade more accurately than MET-PET/CT. The characteristics of FLT-PET/CT can overcome the weakness of MET-PET/CT for differentiating gliomas according to the 2016 WHO classification.

scholarly journals Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

2020 ◽  
Author(s):  
Tomoya Ogawa ◽  
Nobuyuki Kawai ◽  
Keisuke Miyake ◽  
Aya Shinomiya ◽  
Yuka Yamamoto ◽  
...  
Keyword(s):  
Who Classification ◽  
Idh1 Mutation ◽  
Histopathological Diagnosis ◽  
Newly Diagnosed ◽  
Mutation Status ◽  
Flt Pet ◽  
Molecular Features ◽  
Pet Ct ◽  
The Mean ◽  
Met Pet

Abstract Background The molecular features of isocitrate dehydrogenase ( IDH ) mutation and chromosome 1p and 19q (1p/19q) codeletion status have pivotal role for differentiating gliomas and have been integrated in the World Health Organization (WHO) classification in 2016. Positron emission tomography (PET) with 18 F-fluorothymidine (FLT) has been used to evaluate tumour grade and proliferative activity and compared with L-methyl- 11 C-methionine (MET) in glioma patients. Herein, we evaluated tracer uptakes of MET-PET/CT and FLT-PET/CT for differentiating glioma based on the 2016 WHO classification especially in relation to IDH1 mutation status. Methods In total, 81 patients with newly diagnosed supratentorial glioma were enrolled in this study. They underwent PET/CT studies with MET and FLT before surgery. The molecular features and histopathological diagnosis based on the 2016 WHO classification were determined using surgical specimens. The ratios of the maximum standardized uptake value (SUV) of the tumours to the mean SUV of the contralateral cortex (T/N ratios) were calculated on MET-PET/CT and FLT-PET/CT images. Results The mean T/N ratios of MET-PET/CT and FLT-PET/CT in IDH1 -wildtype tumours were significantly higher than those in IDH1 -mutant tumours ( P <0.001 and P <0.001, respectively). Receiver operating characteristic analysis for differentiating IDH1 mutation status showed that the area under the curve of the FLT T/N ratio was significantly larger than that of the MET T/N ratio ( P <0.01). The mean T/N ratio of FLT-PET/CT in IDH1 -wildtype tumours was significantly higher than that in IDH1 -mutant tumours among grade Ⅱ and Ⅲ gliomas ( P =0.005), but this was not the case for MET-PET/CT. Both MET-PET/CT and FLT-PET/CT were able to distinguish between grade Ⅱ and Ⅲ gliomas in IDH1 -mutant tumours ( P =0.002 and P <0.001, respectively), but only FLT-PET/CT was able to distinguish between grade Ⅲ and Ⅳ gliomas in IDH1 -wildtype tumours ( P =0.029). Conclusion This study showed that FLT-PET/CT can be used to determine the IDH1 mutation status and evaluate glioma grade more accurately than MET-PET/CT. FLT-PET/CT can improve glioma differentiation based on the 2016 WHO classification, but caution must be paid for tumours without contrast enhancement.

scholarly journals NI-20 IS GLIOMATOSIS CEREBRI DIAGNOSED AS GRADEII IN NEUROIMAGING A POTENTIALLY GRADEII GLIOMA?

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii29-ii29
Author(s):  
Etsuko Owashi ◽  
Hiroaki Takei ◽  
Yuka Ikegame ◽  
Yoshitaka Asano ◽  
Kazuhiro Miwa ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Who Classification ◽  
Gliomatosis Cerebri ◽  
World Health ◽  
Resonance Spectroscopy ◽  
Diffuse Glioma ◽  
Diffuse Astrocytoma ◽  
Positron Emission ◽  
The Mean ◽  
Met Pet

Abstract The 2007 World Health Organization (WHO) classification defined gliomatosis cerebri (GC) as a rare entity and an extensively infiltrating diffuse glioma involving three or more cerebral lobes. Although the revised 2016 WHO classification removed GC as a separate glioma entity due to the common histopathological findings shared with other gliomas, GC exhibits a distinct growth pattern and worse prognosis compared with other grade-matched gliomas. We retrospectively reviewed five patients with GC and five patients with insulo-opercular diffuse astrocytoma (IODA) who underwent both proton magnetic resonance spectroscopy (MRS) and [11C]-methionine positron emission tomography (MET-PET). The patients were diagnosed with GC or IODA by T2-weighted magnetic resonance imaging /fluid-attenuated inversion recovery from April 2014 to August 2019 at our institution. The locations of lesions where single-voxel MRS to measure the N-acetylaspartate (NAA)/choline (Cho) ratio and MET-PET to measure the tumor/normal (T/N) ratio were performed were the same in every patient. The mean age of all patients was 46.3±13.7 years. The mean ages of the GC (three males and two females) and IODA (two males and three females) groups were 54.0±14.0 and 38.6±8.7 years, respectively. The mean NAA/Cho ratios in the GC and IODA groups were 1.010±0.441 and 0.594±0.449, respectively. The mean T/N ratios in the GC and IODA groups were 1.201±0.050 and 1.169±0.009, respectively. The higher NAA/Cho ratio in the GC lesions may reflect the abundance of normal neural tissue in GC compared with IODA. Nonetheless, the T/N ratios of the two groups were comparable. The discrepancy suggests that GC cells have higher tumor metabolic activity than IODA cells. Therefore, when GC is simply classified as grade II glioma based on neuroimaging diagnosis, the possibility of underestimating its malignant potential at the single-cell level should be considered.

Usefulness of positron emission tomography for differentiating gliomas according to the 2016 World Health Organization classification of tumors of the central nervous system

2020 ◽  
Vol 133 (4) ◽  
pp. 1010-1019 ◽  
Author(s):  
Hiroaki Takei ◽  
Jun Shinoda ◽  
Soko Ikuta ◽  
Takashi Maruyama ◽  
Yoshihiro Muragaki ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Pet Imaging ◽  
Who Classification ◽  
Standardized Uptake Value ◽  
Emission Tomography ◽  
World Health ◽  
Pet Tracers ◽  
Positron Emission ◽  
Significant Difference ◽  
The Mean

OBJECTIVEPositron emission tomography (PET) is important in the noninvasive diagnostic imaging of gliomas. There are many PET studies on glioma diagnosis based on the 2007 WHO classification; however, there are no studies on glioma diagnosis using the new classification (the 2016 WHO classification). Here, the authors investigated the relationship between uptake of 11C-methionine (MET), 11C-choline (CHO), and 18F-fluorodeoxyglucose (FDG) on PET imaging and isocitrate dehydrogenase (IDH) status (wild-type [IDH-wt] or mutant [IDH-mut]) in astrocytic and oligodendroglial tumors according to the 2016 WHO classification.METHODSIn total, 105 patients with newly diagnosed cerebral gliomas (6 diffuse astrocytomas [DAs] with IDH-wt, 6 DAs with IDH-mut, 7 anaplastic astrocytomas [AAs] with IDH-wt, 24 AAs with IDH-mut, 26 glioblastomas [GBMs] with IDH-wt, 5 GBMs with IDH-mut, 19 oligodendrogliomas [ODs], and 12 anaplastic oligodendrogliomas [AOs]) were included. All OD and AO patients had both IDH-mut and 1p/19q codeletion. The maximum standardized uptake value (SUV) of the tumor/mean SUV of normal cortex (T/N) ratios for MET, CHO, and FDG were calculated, and the mean T/N ratios of DA, AA, and GBM with IDH-wt and IDH-mut were compared. The diagnostic accuracy for distinguishing gliomas with IDH-wt from those with IDH-mut was assessed using receiver operating characteristic (ROC) curve analysis of the mean T/N ratios for the 3 PET tracers.RESULTSThere were significant differences in the mean T/N ratios for all 3 PET tracers between the IDH-wt and IDH-mut groups of all histological classifications (p < 0.001). Among the 27 gliomas with mean T/N ratios higher than the cutoff values for all 3 PET tracers, 23 (85.2%) were classified into the IDH-wt group using ROC analysis. In DA, there were no significant differences in the T/N ratios for MET, CHO, and FDG between the IDH-wt and IDH-mut groups. In AA, the mean T/N ratios of all 3 PET tracers in the IDH-wt group were significantly higher than those in the IDH-mut group (p < 0.01). In GBM, the mean T/N ratio in the IDH-wt group was significantly higher than that in the IDH-mut group for both MET (p = 0.034) and CHO (p = 0.01). However, there was no significant difference in the ratio for FDG.CONCLUSIONSPET imaging using MET, CHO, and FDG was suggested to be informative for preoperatively differentiating gliomas according to the 2016 WHO classification, particularly for differentiating IDH-wt and IDH-mut tumors.

scholarly journals Diagnostic value of PET/CT with 11C-methionine (MET) and 18F-fluorothymidine (FLT) in newly diagnosed glioma based on the 2016 WHO classification

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Tomoya Ogawa ◽  
Nobuyuki Kawai ◽  
Keisuke Miyake ◽  
Aya Shinomiya ◽  
Yuka Yamamoto ◽  
...  
Keyword(s):  
Who Classification ◽  
Diagnostic Value ◽  
Newly Diagnosed ◽  
Pet Ct

Pharmacodynamic phase I study using FLT PET/CT in advanced solid malignancies treated with a sequential combination of X-82 and docetaxel.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e14088-e14088
Author(s):  
Gil Edward Harmon ◽  
Murtuza M. Rampurwala ◽  
Matt Scarpelli ◽  
Jens C. Eickhoff ◽  
Lakeesha Carmichael ◽  
...  
Keyword(s):  
Day Treatment ◽  
Vascular Complications ◽  
Therapeutic Window ◽  
Tumor Proliferation ◽  
Angiogenic Therapy ◽  
Flt Pet ◽  
Pet Ct ◽  
Medicine Physician ◽  
Sequential Combination ◽  
The Mean

e14088 Background: Increased tumor proliferation has been observed during withdrawal of anti-angiogenic therapy, known as withdrawal flare, which has been demonstrated using [18-F] fluorothymidine [FLT] PET/CT . Sequencing chemotherapy may increase therapeutic window by better synchronizing treatment with tumor proliferation during the flare. This study utilizes FLT PET/CT to assess X-82, a novel VEGFR TKI, used in sequence with docetaxel. Methods: Pts with at least 1 lesion evaluable with FLT PET/CT underwent 21-day treatment cycles with X-82 daily on days 2-15. Starting in cycle 2 (C2), docetaxel was given on day 1 of each cycle. FLT PET/CTs were obtained on days 1 and 15 in cycles 1 and 2. Tumors were identified by a nuclear medicine physician and manually segmented. The maximum tumor FLT uptake SUVmax and the total tumor FLT uptake SUVtotal were extracted for each tumor. To quantify changes in tumor FLT uptake, SUVs were log transformed and included in mixed effects models with random effects accounting for intrapatient correlation of tumor responses. Results: 14 pts were treated with median 3.5 cycles (range 0-12). 4 pts with 13 metastatic tumors completed all PET scans and were included in the pharmacodynamic assessment. 1 pt had an unconfirmed PR and 7 pts had stable disease per RECIST 1.1. The mean percent (%) change in tumor SUV during C1 (X-82 monotherapy) was -13% for SUVmax (P = 0.04) and -17% for SUVtotal (P = 0.14). The mean % change in tumor SUV during C2 (X-82 + docetaxel) was -44% for SUVmax (P = 0.03) and -59% for SUVtotal (P < 0.01). There was a significantly greater decrease in SUV in C2 than in C1 for both SUVmax (P = 0.03) and SUVtotal(P = 0.02). Ten grade 3 AEs possibly related to X-82 were noted in 6 pts, including infections, cytopenias, and vascular complications. Conclusions: Diminished tumor proliferation was observed during X-82 treatment, indicating successful targeting of VEGFRs. Sequential combination of X-82 plus docetaxel showed greater decreases in tumor proliferation compared to X-82 monotherapy indicating value in sequencing chemotherapy during VEGFR TKI treatment breaks. There is evidence that combination therapy is both safe and effective. Clinical trial information: NCT 02146222.

Clinical characterization of acute myeloid leukemia with myelodysplasia-related changes as defined by the 2008 WHO classification system

Blood ◽  
2009 ◽  
Vol 113 (9) ◽  
pp. 1906-1908 ◽  
Author(s):  
Olga K. Weinberg ◽  
Mahesh Seetharam ◽  
Li Ren ◽  
Katie Seo ◽  
Lisa Ma ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Who Classification ◽  
Progression Free Survival ◽  
World Health ◽  
Multilineage Dysplasia ◽  
Molecular Features ◽  
Not Otherwise Specified ◽  
Cebpa Mutations ◽  
Acute Myeloid

Although some studies have validated the 2001 World Health Organization (WHO) classification of acute myeloid leukemia (AML), including the importance of multilineage dysplasia, others have suggested that multilineage dysplasia correlates with unfavorable cytogenetics but has no independent impact on prognosis. In 2008, the revised WHO classification has expanded this category into “AML with myelodysplasia-related changes” (AML-MRC). We evaluated the clinical, pathologic, cytogenetic, and molecular features of 100 AML patients using the 2008 WHO criteria. Patients underwent genetic screening for NPM1, FLT3-ITD, FLT3-D835, and CEBPA mutations. Compared with patients with AML, not otherwise specified, patients with AML-MRC were significantly older (P = .014), presented with a lower hemoglobin (P = .044), more frequently expressed CD14 (P = .048), and exhibited a decreased frequency of CEBPA mutations (P = .001). Multivariate analysis indicated that patients with AML-MRC had a significantly worse overall survival, progression-free survival, and complete response compared with AML-not otherwise specified (all P < .001). These data support the clinical, morphologic, and cytogenetic criteria for this 2008 WHO AML category.

18F-fluorothymidine (FLT) PET-CT for early response assessment in advanced pancreatic cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21093-e21093
Author(s):  
Amarnath Challapalli ◽  
Harpreet S Wasan ◽  
Adil Al-Nahhas ◽  
Eric Aboagye ◽  
Charles Coombes ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Standardized Uptake Value ◽  
Response To Therapy ◽  
Pancreatic Tumors ◽  
Metastatic Tumors ◽  
Flt Pet ◽  
Pet Ct ◽  
The Mean

e21093 Background: Advanced pancreatic cancer has a poor prognosis with a median survival of 6-10 months. There is a need for early non-invasive assessment of treatment response. We evaluated FLT PET-CT combined with a kinetic spatial filtering method (FLT-PETKSF) for detecting response to gemcitabine-based chemotherapy in advanced pancreatic cancer. Methods: Dynamic FLT PET-CT data were collected from patients with confirmed locally advanced or metastatic pancreatic cancer before and 2 weeks after the first cycle of chemotherapy. Changes in tumor FLT-PET variables with treatment were determined. Standardized uptake value (SUV) reduction of 18% was taken as cut-off for response. Voxel quantification of each tumor volume was performed on the filtered data. Each voxel-intensity was normalised by injected dose, body weight and decay corrected to obtain the SUV for the voxel. Changes in high intensity voxels (HiVox: SUV ≥ 2) - were computed. Results: Results of the first 5 patients are discussed. There were 4 primary and 9 metastatic tumors. FLT-PETKSF improved tumor-to-background ratio and enabled visualisation of all the primary and metastatic tumors. The mean (± SD) average and maximum SUV at 60 min (SUV60, av & SUV60, max) of the primary lesions was 2.10 (±0.38) & 4.85 (±1.55) and that of the metastatic lesions was 3.74 (±1.49) & 6.90 (±2.05) respectively. The mean (± SD) percentage reduction in the SUV60, av & SUV60, max, HIVox was 26 (±44), 18 (±38) and 23 (±50) respectively. The changes in the voxel occurrences correlated strongly with the changes in both SUV60, av & SUV60, max (Pearson r-0.9, p=0.001) .Overall, there were 2 partial responders and 3 with stable disease. These responses concurred with response evaluation on mid-treatment CT scan. Conclusions: FLT-PET and FLT-PETKSF enables visualisation of the pancreatic tumors and the liver metastases, and could be used to monitor response to therapy.

scholarly journals Fractal analysis of 11C-methionine PET in patients with newly diagnosed glioma

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Yukito Maeda ◽  
Yuka Yamamoto ◽  
Takashi Norikane ◽  
Katsuya Mitamura ◽  
Tetsuhiro Hatakeyama ◽  
...  
Keyword(s):  
Fractal Dimension ◽  
Fractal Analysis ◽  
Anaplastic Astrocytoma ◽  
Idh1 Mutation ◽  
Lower Grade ◽  
Diffuse Astrocytoma ◽  
Newly Diagnosed ◽  
Mutation Status ◽  
Lower Grade Glioma ◽  
Met Pet

Abstract Background The present study tested the possible utility of fractal analysis from l-[methyl-11C]-methionine (MET) uptake in patients with newly diagnosed gliomas for differentiating glioma, especially in relation to isocitrate dehydrogenase 1 (IDH1) mutation status, and as compared with the conventional standardized uptake value (SUV) parameters. Methods Investigations of MET PET/CT were performed retrospectively in 47 patients with newly diagnosed glioma. Tumors were divided into three groups: lower grade glioma (IDH1-mutant diffuse astrocytoma and IDH1-mutant anaplastic astrocytoma), higher grade glioma (IDH1-wildtype diffuse astrocytoma and IDH1-wildtype anaplastic astrocytoma), and glioblastoma. The fractal dimension for tumor, maximum SUV (SUVmax) for tumor (T) and mean SUV for normal contralateral hemisphere (N) were calculated, and the tumor-to-normal (T/N) ratio was determined. Metabolic tumor volume (MTV) and total lesion MET uptake (TLMU) were also measured. Results There were significant differences in SUVmax (p = 0.006) and T/N ratio (p = 0.02) between lower grade glioma and glioblastoma. There were no significant differences among any of the three groups in MTV or TLMU. Significant differences were obtained in the fractal dimension between lower grade glioma and higher grade glioma (p = 0.006) and glioblastoma (p < 0.001). Conclusions The results of this preliminary study in a small patient population suggest that the fractal dimension using MET PET in patients with newly diagnosed gliomas is useful for differentiating glioma, especially in relation to IDH1 mutation status, which has not been possible with SUV parameters.

Angioimmunoblastic T-Cell Lymphoma (AITL) Is the Most Prevalent T-Cell Lymphoma Entity in Western Europe

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1607-1607 ◽  
Author(s):  
Marie Parrens ◽  
Antoine Martin ◽  
Laurence Lamant ◽  
Richard Delarue ◽  
Corinne Haioun ◽  
...  
Keyword(s):  
T Cell ◽  
Western Europe ◽  
Who Classification ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Histopathological Diagnosis ◽  
Relative Distribution ◽  
Newly Diagnosed ◽  
Angioimmunoblastic T Cell Lymphoma ◽  
The Past

Abstract Abstract 1607 Background: Lymphoid malignancies derived from T and NK cells (PTCLs) constitute a heterogeneous group of uncommon disease entities, with marked geographic variation in their distribution. The most recent data from the International T-cell Lymphoma Project based on a retrospective analysis of PTCLs diagnosed between 1990 and 2002 (Blood. 2011;117(25): 6756–67) indicate that PTCL, not otherwise specified (PTCL,NOS) represents the most common PTCL worldwide (25,9%), followed by angioimmunoblastic T-cell lymphoma (AITL) (18,5%). Over the last few years, a better characterization of the cellular origin and pathophysiology of PTCLs has led to the development of new diagnostic markers. Aim of the study: To characterize the epidemiology of mature T/NK-cell malignancies in Western Europe (France and bordering countries) and to examine whether the availability of new tools/antibodies and changing concepts over the past years might have translated into an apparent change in the relative distribution of PTCL entities. Materials and methods: The histopathological diagnosis of PTCL entities according to the 2008 WHO classification were collected through two independent sets of PTCLs in France and bordering countries. Results: Over the past two years (2010–2011), 933 newly diagnosed non-cutaneous PTCLs were reviewed in reference centers through the prospective network “Lymphopath” aiming to review any newly diagnosed lymphoma in France. According to the 2008 WHO classification, the 933 PTCLs comprised: 314 AITL (33,6%), 239 PTCL,NOS (25,6%), 78 ALK-positive anaplastic large cell lymphoma (ALCL) (8,3%), 72 ALK-negative ALCL (7,7%), 59 extranodal NK/T-cell lymphomas (ENKTL 6%), 33 enteropathy-associated T-cell lymphoma (4%), 32 HTLV1+ adult T leukemia/lymphoma (3%), 7 hepatosplenic T-cell lymphoma (1%) and 99 cases of other entities or unclassifiable (11%). A high prevalence of AITL was also found in an independent set of PTCLs retrospectively collected in the framework of a multicentric T-cell lymphoma research consortium “Tenomic” where non-cutaneous PTCL with frozen material available (n=623) from 1999 to 2009 in France and Belgium were retrieved and collegially reviewed for consensus diagnosis. In this collection, AITL (n=288, 46%) also outnumbered PTCL, NOS (n=215, 35%). Of the 196 AITL cases extensively investigated for CD10, TFH markers (PD1, CXCL13), CD21/CD23 follicular dendritic cells (FDC) and EBV, the initial diagnosis was recorded in 178 cases as: AITL in 155 cases (87%), PTCL, NOS in 21 cases (12%), and intermediate between PTCL,NOS and AITL (PTCL,NOS/AITL) in 2 cases, indicating the impact of additional stainings for the diagnosis of AITL. The 107 PTCL,NOS cases also extensively immunostained included 9 follicular variant of PTCL,NOS, 8 PTCL,NOS/AITL cases, 5 cases intermediate between PTCL,NOS and ALK-negative ALCL (of which 2 had been diagnosed as such and two as PTCL,NOS), and 85 remaining cases truly unspecified. Of these, 60 had been initially diagnosed as PTCL,NOS; 2 as PTCL,NOS/AITL; 4 as ALK-negative ALCLs and 1 as ENKTL. Conclusion: This study based on two independent large cohorts of non-cutaneous PTCLs highlights AITL as the most prevalent entity in Western Europe. It shows that extensive studies including investigation for CD10, TFH markers, FDC and EBV can at least partly contribute to the reclassification of some PTCL, NOS into the AITL spectrum category. Disclosures: No relevant conflicts of interest to declare.

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