Targeting personalized medicine in a non-Hodgkin lymphoma patient with 18F-FDG and 18F-choline PET/CT

Early diagnosis and staging of non-Hodgkin lymphoma (NHL) is essential for therapeutic strategy decision. Positron emission tomography/computed tomography (PET/CT) with fluordeoxyglucose (FDG), a glucose analogue, labeled with fluor-18 (F-18-FDG) has been used to evaluate staging, therapy response and prognosis in NHL patients. However, in some cases, F-18-FDG has shown false-positive uptake due to inflammatory reaction after chemo and/or radiation therapy. In this case report, we present a NHL patient evaluated with F-18-FDG and F-18-choline PET/CT scan imaging pre- and post-therapy. F-18-FDG and F-18-choline PET/CT were performed for the purpose of tumor staging and have shown intense uptake in infiltrative tissue as well as in the lymph node, but with some mismatching in the tumor. Post-treatment F-18-FDG and F-18-choline PET/CT scans revealed no signs of radiotracer uptake, suggesting complete remission of the tumor. F-18-choline may be a complimentary tool for staging and assessment of therapeutic response in non-Hodgkin lymphoma, while non-F-18-FDG tracer can be used for targeted therapy and patient management.