Document Detail

18F-FDG PET versus CT for the detection of enteropathy-associated T-cell lymphoma in refractory celiac disease.
MedLine Citation:
PMID:  17015897     Owner:  NLM     Status:  MEDLINE    
Refractory celiac disease (RCD) can evolve into enteropathy-associated T-cell lymphoma (EATL). 18F-FDG PET has been reported to discriminate between RCD and EATL. Because prospective data are lacking, we designed a prospective study to evaluate the potential of 18F-FDG PET for detection of EATL in patients with RCD and compared the results with those obtained using abdominal CT in a referral center. METHODS: Between April 2003 and April 2005, 8 consecutive patients (median age, 66 y; range, 52-89 y) with EATL and 30 patients (median age, 61 y; range, 44-71 y) with RCD were included. CT and 18F-FDG PET were performed on all patients. Histologic evidence of EATL was identified in tissue samples obtained during upper gastrointestinal endoscopy or surgical resection. RESULTS: Villous atrophy was found in all patients with RCD and all (except 1) patients with EATL in nontumoral mucosa. Histologic examination of 1 patient with EATL localized in the duodenum showed intraepithelial lymphocytosis only. 18F-FDG PET could reveal sites histologically proven to be EATL in all 8 patients, whereas CT showed normal findings in 1 patient with EATL. 18F-FDG PET detected unsuspected extraintestinal sites affected by EATL in 2 patients. CT showed abnormalities such as a thickened small-bowel wall or lymphadenopathy in 14 patients with RCD lacking evidence of EATL at follow-up. 18F-FDG PET findings were positive in 3 and equivocal in another 3 patients with RCD. 18F-FDG PET was more sensitive and specific than CT (100% vs. 87% and 90% vs. 53%, respectively). CONCLUSION: Our data show that 18F-FDG PET is more sensitive in detecting EATL in patients with RCD than is CT. 18F-FDG PET, in addition to conventional CT, is recommended for evaluating patients with RCD.
Muhammed Hadithi; Maarten Mallant; Joost Oudejans; Jan-Hein T M van Waesberghe; Chris J Mulder; Emile F I Comans
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of nuclear medicine : official publication, Society of Nuclear Medicine     Volume:  47     ISSN:  0161-5505     ISO Abbreviation:  J. Nucl. Med.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-10-03     Completed Date:  2006-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0217410     Medline TA:  J Nucl Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1622-7     Citation Subset:  IM    
Department of Gastroenterology, VU University Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Aged, 80 and over
Celiac Disease / complications*
Duodenum / pathology,  radiography,  radionuclide imaging
Fluorodeoxyglucose F18 / diagnostic use*
Intestinal Mucosa / pathology,  radiography,  radionuclide imaging
Intestinal Neoplasms / etiology,  radiography,  radionuclide imaging*
Longitudinal Studies
Lymphatic Diseases / etiology,  radiography,  radionuclide imaging
Lymphoma, T-Cell / etiology,  radiography,  radionuclide imaging*
Middle Aged
Positron-Emission Tomography
Radiography, Abdominal
Radiopharmaceuticals / diagnostic use*
Sensitivity and Specificity
Tomography, Emission-Computed / methods
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18

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