Page 41 - ARNM-2-1

Advances in Radiotherapy &

Nuclear Medicine

SHORT COMMUNICATION
18 F-FDG positron emission tomography-

computed tomography and Richter
transformation: A retrospective study with a

cohort of 12 consecutive patients

Salah Oueriagli Nabih*, Chaymae Bensaid, Meryem Aboussabr,
Omar Ait Sahel, Yassir Benameur, and Abderrahim Doudouh

Department of Nuclear Medicine, Mohammed V Military Teaching Hospital, Mohamed V University,
Rabat, Morocco

Abstract

Richter transformation (RT) refers to a transformational process of chronic lymphocytic
leukemia (CLL) into a more aggressive form. CLL is considered an indolent lymphoma
with no avidity to F-fluorodeoxyglucose positron emission tomography/computed
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tomography ( F-FDG PET/CT). RT transforms CLL into a diffuse large B-cell
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lymphoma, Hodgkin’s lymphoma, or prolymphocytic leukemia, and the lymphoid
tissue becomes highly FDG avid. The main value of F-FDG PET/CT in CLL patients
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lies in its ability to exclude RT with high negative predictive value and identify sites
of increased F-FDG uptake that is suitable for biopsy. In our retrospective analysis,
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*Corresponding author:
Salah Oueriagli Nabih we examined 12 patients suspected of RT, who were included in our study between
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(salah.nabihoueriagli@gmail.com) November 2018 and December 2022. F-FDG PET/CT was considered for patients
with enlarged lymph node, fever, and elevated lactate dehydrogenase levels. A
Citation: Nabih SO, Bensaid C,
Aboussabr M, Sahel OA, cutoff standardized uptake value (SUVmax) = 5 was chosen empirically based on our
Benameur Y, Doudouh A. F-FDG institutional practice. Extranodal disease was suspected if abnormal F-FDG uptake
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positron emission tomography- was observed in the liver, spleen, bone marrow, or another organ. In this study, the
computed tomography and Richter
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transformation: A retrospective specificity of F-FDG PET/CT was 44.5%, with positive and negative predictive values
study with a cohort of 12 of 37.5% and 100%, respectively. Frequencies of cases with increased uptake of F-
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consecutive patients. Adv Radiother FDG in the “only nodal sites” and “nodal and extranodal sites,” relative to positive
Nucl Med. 2024;2(1):2431.
https://doi.org/10.36922/arnm.2431 biopsies, were 20% and 66%, respectively.
Received: December 14, 2023
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Accepted: March 15, 2024 Keywords: F-FDG PET/CT; Predictive value; Chronic lymphocytic leukemia; Richter
syndrome transformation
Published Online: March 27, 2024
Copyright: © 2024 Author(s).
This is an Open-Access article
distributed under the terms of the 1. Introduction
Creative Commons Attribution
License, permitting distribution, Chronic lymphocytic leukemia (CLL) is an indolent disease characterized by the
and reproduction in any medium,
provided the original work is proliferation of B-cell lymphocytes. CLL may be converted into a more aggressive
properly cited. type, usually a diffuse large B-cell lymphoma (DLBCL) and less frequently a Hodgkin’s
Publisher’s Note: AccScience lymphoma or prolymphocytic leukemia, through a process called Richter transformation
Publishing remains neutral with (RT). The early detection of RT and identification of high-risk CLL patients are
1,2
regard to jurisdictional claims in
published maps and institutional performed with hybrid metabolic imaging using 18-flu=orine fluorodeoxyglucose
affiliations. positron emission tomography-computed tomography ( F-FDG PET/CT) owing to
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Volume 2 Issue 1 (2024) 1 https://doi.org/10.36922/arnm.2431