The Correlation Between Pre-treatment Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Parameters and Clinical Prognostic Factors in Pediatric Hodgkin Lymphoma

OBJECTIVE: To compare standardized uptake values (SUV) derived from pre-treatment 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging and clinical prognostic factors in pediatric patients with Hodgkin lymphoma (HL). METHODS: Pre-treatment FDG PET/CT findings of 28 children with HL were evaluated in this retrospective study. Metabolic tumor volume (MTV), SUV(max) normalized by weight (SUVw(eight)), lean body mass (SUV(lbm)), body surface area (SUV(bsa)) and plasma glucose levels of tumors (SUV(glucose)) were calculated using pre-treatment FDG PET/CT scan images. These metabolic parameters were correlated with clinical factors [age, sex, number of lymph node groups, presence of splenic involvement, bulky mediastinal disease, Ann Arbor stage, serum white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), serum albumin and hemoglobin levels]. RESULTS: SUV(bsa), SUV(lbm), SUV(weight), SUV(glucose) and MTV were higher in patients with stage III-IV disease, bulky tumor and ≥3 lymph node groups (p<0.05). SUV(bsa) and SUV(glucose) were higher in patients with splenic involvement (p<0.05). There was no significant correlation between these metabolic parameters and sex, ESR, levels of albumin and WBC (p>0.05). SUV(bsa) and SUV(lbm) were higher in patients with anemia (p<0.05). Additionally, significant increases were detected in SUV(weight), MTV, and SUV(glucose) with increasing age (p=0.005, p=0.027, and p=0.009, respectively). SUV(bsa) and SUV(lbm) had no significant correlation with age (p>0.05). CONCLUSION: Metabolic parameters derived from pre-treatment FDG PET/CT may have an important role in predicting high-risk disease in patients with HL. Also, SUV(bsa) and SUV(lbm) may be better markers than SUV(weight) in the quantitative evaluation of FDG PET/CT scans in pediatric patients.