Is There a Role for [18F]FDG PET-CT in Staging MALT Lymphoma?

Dan Cohen, Chava Perry, Shir Hazut-Krauthammer, Mikhail Kesler, Yair Herishanu, Efrat Luttwak, Einat Even-Sapir, Irit Avivi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


The role of18F-fluorodeoxyglucose ([18F]FDG) positron emission tomography—computed tomography (PET-CT) in assessing mucosa-associated lymphoid tissue (MALT) lymphoma is de-batable. We retrospectively explored the role of [18F]FDG PET-CT in staging and predicting progres-sion-free-survival (PFS) of patients with newly-diagnosed MALT lymphoma. Sixty-six studies were included. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were documented in the “hottest” extranodal and nodal lesions. Extranodal lesions and accompanying nodal disease were detected on PET in 38/66 (57.6%) and 13/66 (19.7%) studies, respectively. Detection rate of extranodal lesions differed significantly between those located in tissues with high/heterogeneous (e.g., stomach) vs low/homogenous (e.g., subcutaneous-tissue, lung) physiologic [18F]FDG-uptake (40.4% vs. 100%, p < 0.01). Nodal lesions had significantly lower SUVmax, MTV and TLG compared with extrandodal lesions in the same patients. Detection and [18F]FDG-avidity of extranodal lesions were higher in patients with ad-vanced, bulky disease and concomitant marrow/nodal involvement. Increased SUVmax of extran-odal lesions predicted shorter PFS (HR 1.10, 95% CI 1.01–1.19, p = 0.02). Higher SUVmax and TLG showed trends towards shorter PFS in patients with localized disease. In conclusion, detection rate of extranodal MALT lymphoma lesions located in tissues with low/homogeneous physiologic [18F]FDG-uptake is excellent on [18F]FDG PET-CT. When detected, SUVmax of extranodal lesions may predict PFS.

Original languageEnglish
Article number750
Issue number3
StatePublished - 1 Feb 2022


  • Detection rate
  • MALT lymphoma
  • Physiologic [F]FDG-uptake
  • SUVmax
  • [F]FDG


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