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SUV on Dual-Phase FDG PET/CT Correlates With the Ki-67 Proliferation Index in Patients With Newly Diagnosed Non-Hodgkin Lymphoma

Chang, Chin-Chuan MD*; Cho, Shih-Feng MD; Chen, Yu-Wen MD*‡; Tu, Hung-Pin PhD§; Lin, Chia-Yang MD*; Chang, Chao-Sung MD, PhD†∥

doi: 10.1097/RLU.0b013e318251e16e
Original Articles

Purpose PET using 18F-FDG integrated with CT is beneficial for staging patients with non-Hodgkin lymphoma (NHL). The Ki-67 index is used to assess the proliferation potential of tumor cells. The aim of this study was to evaluate the correlation of the Ki-67 index in tissue samples with the SUV at different sites on dual-phase FDG PET/CT of patients with newly diagnosed NHL.

Materials and Methods From September 2009 to March 2011, patients with newly diagnosed NHL who had received dual-phase FDG PET/CT for staging and biopsy samples that were evaluated for the Ki-67 expression were enrolled. The SUVmax of the biopsy site, the tumorous lesion sites, and 3 different bone marrow sites (right iliac crest, sternum, and L1) were measured. The SUVmean of the liver and spleen were also measured.

Results There were a total of 27 patients in this study. Significant correlations were observed between the Ki-67 index and the SUVmax of the right iliac crest in patients with early-stage disease (stage I and II) patients, the SUVmax of the biopsy and whole-body lesion sites in patients with late-stage disease (stage III and IV), and the retention index of SUVmax of the right iliac crest in patients whose bone marrow were involved by lymphoma cells.

Conclusions For patients with newly diagnosed NHL, the significant correlation between the Ki-67 index and the SUV in this study suggests that dual-phase FDG PET/CT may be used as a noninvasive measurement of tumor proliferation.

From the *Department of Nuclear Medicine, Kaohsiung Medical University Hospital, †Division of Hematology & Oncology, Department of Internal Medicine, ‡School of Medicine, and §Department of Public Health and Environmental Medicine, College of Medicine, and ||Graduate Institute of Healthcare Administration, Kaohsiung Medical University, Kaohsiung, Taiwan.

Received for publication June 21, 2011; revision accepted February 21, 2012.

Conflicts of interest and sources of funding: none declared.

Reprints: Chao-Sung Chang, MD, PhD, No. 100 Tzyou 1st Rd, Kaohsiung City, 80756, Taiwan. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.