Factors affecting intrapatient liver and mediastinal blood pool super(18)F-FDG standardized uptake value changes during ABVD chemotherapy in Hodgkin's lymphoma

Purpose: The aim of our study was to assess the intrapatient variability of 2-deoxy-2-( super(18)F)-fluoro-D-glucose ( super(18)F-FDG) uptake in the liver and in the mediastinum among patients with Hodgkin's lymphoma (HL) treated with doxorubicin (Adriamycin), bleomycin, vinblastine and dacarbazine (ABVD) chemotherapy (CHT). Methods: The study included 68 patients (30 men, 38 women; mean age 32 plus or minus 11 years) with biopsy-proven HL. According to Ann Arbor criteria, 6 were stage I, 34 were stage II, 12 were stage 3 and 16 were stage 4. All of them underwent a baseline (PET0) and an interim (PET2) super(18)F-FDG whole-body positron emission tomography (PET)/CT. All patients were treated after PET0 with two ABVD cycles for 2 months that ended 15 plus or minus 5 days prior to the PET2 examination. All patients were further evaluated 15 plus or minus 6 days after four additional ABVD cycles (PET6). None of the patients presented a serum glucose level higher than 107 mg/dl. The mean and maximum standardized uptake values (SUV) of the liver and mediastinum were calculated using the same standard protocol for PET0, PET2 and PET6, respectively. Data were examined by means of the Wilcoxon matched pairs test and linear regression analysis. Results: The main results of our study were an increased liver SUV sub(mean) in PET2 (1.76 plus or minus 0.35) as compared with that of PET0 (1.57 plus or minus 0.31; p