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Whole body positron emission tomography in the treatment of Hodgkin disease
Author(s) -
Hueltenschmidt Beatrix,
SautterBihl MarieLuise,
Lang Oliver,
Maul Frank D.,
Fischer Jörg,
Mergenthaler HansGünther,
Bihl Heiner
Publication year - 2001
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20010115)91:2<302::aid-cncr1002>3.0.co;2-4
Subject(s) - medicine , positron emission tomography , nuclear medicine , positron emission , brain positron emission tomography , medical physics , radiology , preclinical imaging , microbiology and biotechnology , in vivo , biology
BACKGROUND In Hodgkin disease (HD), accurate assessment of the extent of disease is essential because it provides the basis for different treatment strategies. In addition to conventional imaging methods (CIM), positron emission tomography with fluorine‐18‐fluorodeoxyglucose (FDG‐PET) may permit reliable differentiation between lymphoma and nonmalignant tissue and thus improve determination of the stage of the disease. The aim of the current study was to assess the clinical value of FDG‐PET for primary staging, treatment monitoring, and assessment in a suspected case of recurrent HD. METHODS Eighty‐one patients with HD underwent 106 FDG‐PET studies using a dedicated whole body PET ring scanner. In 25 patients PET was part of the primary staging, 63 PET studies were undertaken for treatment monitoring after the completion of treatment, and in 18 patients PET was performed in cases of suspected recurrence of HD. PET scans were compared with CIM and verified histologically and/or by follow‐up evaluation (mean follow‐up duration, 20.4 months). RESULTS With regard to primary staging, in a patient to patient analysis, both PET scans and CIM were positive (i.e., showed pathologic foci indicative of HD) in 24 of 25 cases. In a staging‐relevant lesion to lesion analysis, accuracy in the determination of the stage of disease was 96% for PET versus 56% for CIM. PET led to a lower stage classification in 28% and a higher stage classification in 12% of cases, compared with the stage assumed with CIM. With regard to treatment monitoring, PET showed an accuracy of 91% compared with 62% for CIM. The negative predictive value of PET was 96%. With regard to suspected recurrence, PET findings were true‐positive in 10 of 12 PET scans and true‐negative in 5 of 6 PET scans, resulting in accuracy of 83%, which compares favorably with the accuracy rate of 56% for CIM. CONCLUSIONS It may be concluded that FDG‐PET is capable of determining the stage of HD with great accuracy and is capable of correctly detecting manifestations of HD in treatment monitoring and cases of suspected recurrence, in which CIM occasionally result in equivocal findings. The results of the current study suggest that FDG‐PET should become a routine tool in the staging/restaging of HD. Cancer 2001;91:302–10. © 2001 American Cancer Society.