Increased 18 F-FDG accumulation in the tonsils after chemotherapy for pediatric lymphoma: a common physiological phenome
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Increased 18F-FDG accumulation in the tonsils after chemotherapy for pediatric lymphoma: a common physiological phenomenon Chio Okuyama1,2 · Shigenori Matsushima2 · Motoki Nishimura2 · Kei Yamada2 Received: 17 December 2018 / Accepted: 10 January 2019 © The Japanese Society of Nuclear Medicine 2019
Abstract Objective Increased 18F-fluorodeoxyglucose (FDG) uptake in the tonsils after the completion of chemotherapy in patients with lymphoma may be misdiagnosed as tumor recurrence. This study aimed to investigate the changes in physiological FDG uptake in the tonsils during and after chemotherapy in pediatric patients with lymphoma. Methods A total of 47 FDG-PET/CT scans acquired from 13 pediatric patients with lymphoma (before chemotherapy [preC] = 9; during chemotherapy [durC] = 12; within 1 month after the end of chemotherapy [endC] = 11; and after achieving complete response [postC] = 15) were retrospectively included in this study. FDG uptake in the palatine tonsils was assessed using maximum standardized uptake value ( SUVmax). The relative size of the palatine tonsils was calculated as the tonsilpharyngeal ratio (TPR). Serial changes in the SUVmax and TPR were evaluated. Results The mean SUVmax was 3.7 ± 1.7, 2.6 ± 0.7, 2.3 ± 0.8, and 6.2 ± 1.6, at the preC, durC, endC, and postC scans, respectively (p
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