PET/CT in the evaluation of lymphoma in patients with HIV-1 with suppressed viral loads

Clinical Nuclear Medicine
Elinor GoshenItzchak Levy

Abstract

Positron emission tomography (PET) with F-18 fluorodeoxyglucose detects active lymphoid tissue during HIV-1 infection, with distinct patterns of lymphoid activation correlating to various stages of disease activity. Patients with HIV-1 are at risk for lymphoma, making the differential diagnosis between benign and malignant lymphadenopathy imperative. This study retrospectively evaluated the role of PET/computed tomography (CT) in differentiating active lymphoma from persistent generalized lymphadenopathy in patients with HIV-1. Seven patients with HIV-1 underwent PET/CT. Six, with known non-Hodgkin lymphoma underwent a total of 16 PET/CT scans; 5/16 scans were performed for initial staging, and 10/16 for evaluating treatment response and follow-up. One patient was referred for evaluation of lymphadenopathy suspected of being lymphoma. PET/CT findings were compared with concurrent clinical, immunologic, and virological data. PET/CT accurately depicted the extent of lymphoma in 12/16 patients' scans (75%), yet in 4/16 (25%) scans increased fluorodeoxyglucose uptake was noted in lymph nodes of normal CT appearance (PET+/CT-). Viral loads ranged from 0 to 84,000 copies/mL, CD4 T-cell count ranged from 130 to 474 cells/muL in the gr...Continue Reading

Citations

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