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OtherCLINICAL INVESTIGATIONS

Whole-Body Hybrid PET with 18F-FDG in the Staging of Non-Hodgkin’s Lymphoma

Mitsuaki Tatsumi, Hitoshi Kitayama, Hiroyuki Sugahara, Naoki Tokita, Hironobu Nakamura, Yuzuru Kanakura and Tsunehiko Nishimura
Journal of Nuclear Medicine April 2001, 42 (4) 601-608;
Mitsuaki Tatsumi
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Hitoshi Kitayama
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Hiroyuki Sugahara
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Naoki Tokita
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Hironobu Nakamura
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Yuzuru Kanakura
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Tsunehiko Nishimura
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  • FIGURE 1.
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    FIGURE 1.

    Patient 10. Coronal images obtained by FDG hybrid PET (A) and dedicated PET (B). Bilateral cervical to axillary, mediastinal, and para-aortic to bilateral iliac sites are detected on both sets of images. Clearer images and higher lesion-to-background contrast are achieved with dedicated PET than with hybrid PET.

  • FIGURE 2.
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    FIGURE 2.

    Patient 4. Coronal images obtained by FDG hybrid PET (A) and dedicated PET (B). Left supraclavicular site is clearly depicted by dedicated PET. Hybrid PET, on other hand, shows only faint uptake at corresponding site (arrow), which is not considered pathologic.

  • FIGURE 3.
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    FIGURE 3.

    Patient 24. Diffuse spleen involvement (arrows) is detected by both FDG hybrid PET (A) and dedicated PET (B) (top: coronal; bottom: axial). (C) CT fails to detect involvement, showing only splenomegaly.

  • FIGURE 4.
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    FIGURE 4.

    Patient 1. Images obtained by FDG hybrid PET (A) and dedicated PET (B) (top: coronal; bottom: axial) show hot uptake at mediastinal site (arrows). Eight-millimeter lesion is seen on CT (arrowhead) but was diagnosed as negative for NHL because of size criteria.

  • FIGURE 5.
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    FIGURE 5.

    Patient 12, with indolent, low-risk lymphoplasmacytic lymphoma. Images obtained by both coronal FDG hybrid PET (A) and dedicated PET (B) show only faint uptake at sites that CT (C) shows to have numerous bulky lesions. Lesions extend from cervical to inguinal regions, including mediastinal (arrow) and para-aortic (arrowheads).

Tables

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    TABLE 1

    Summary of Patient Data

    Patient no.Age (y)SexClinical group*Stage†
    148FIndolentII
    241FIndolentIII
    349FIndolentIII
    449FIndolentIII
    564MIndolentIII
    631FIndolentIV
    737MIndolentIV
    839FIndolentIV
    954MIndolentIV
    1054FIndolentIV
    1155FIndolentIV
    1266MIndolentIV
    1373MIndolentIV
    1464MAggressiveI
    1579MAggressiveI
    1679FAggressiveI
    1745FAggressiveII
    1870MAggressiveII
    1971MAggressiveII
    2075MAggressiveII
    2182MAggressiveII
    2262MAggressiveIII
    2363MAggressiveIII
    2466FAggressiveIV
    2566FAggressiveIV
    2669MAggressiveIV
    2772FAggressiveIV
    2875FAggressiveIV
    2914MVery aggressiveIV
    3020MVery aggressiveIV
    • ↵* Indolent lymphoma is low risk, aggressive lymphoma is intermediate risk, and very aggressive lymphoma is high risk.

    • ↵† Stage is based on reference standard.

    • View popup
    TABLE 2

    Distribution of True-Positive Disease Sites Based on FDG Hybrid PET and Dedicated PET, CIS, and Reference Standard

    SiteHybrid PETDedicated PETCISReference standard
    Cervical26292833
    Supraclavicular23272229
    Axillary15182022
    Mediastinal and hilar12141316
    Subtotal: supradiaphragmatic768883100
    Para-aortic13141315
    Abdominal991111
    Iliac21252028
    Inguinal19202224
    Subtotal: infradiaphragmatic62686678
    Splenic4434
    Bone and bone marrow77112
    Other extranodal10121112
    Subtotal: extranodal21231528
    Total159179164206
    • View popup
    TABLE 3

    Comparison of Disease Stage Based on FDG Hybrid PET and Dedicated PET, CIS, and Reference Standard

    StageHybrid PETDedicated PETCISReference standard
    I4  (3)4 (3)4 (3)3
    II7  (6)6 (6)6 (6)6
    III9  (5)9 (5)15 (6)6
    IV10 (10)11 (10)5 (5)15
    • Numbers in parentheses are numbers concordant with reference standard.

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Journal of Nuclear Medicine
Vol. 42, Issue 4
April 1, 2001
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Whole-Body Hybrid PET with 18F-FDG in the Staging of Non-Hodgkin’s Lymphoma
Mitsuaki Tatsumi, Hitoshi Kitayama, Hiroyuki Sugahara, Naoki Tokita, Hironobu Nakamura, Yuzuru Kanakura, Tsunehiko Nishimura
Journal of Nuclear Medicine Apr 2001, 42 (4) 601-608;

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Whole-Body Hybrid PET with 18F-FDG in the Staging of Non-Hodgkin’s Lymphoma
Mitsuaki Tatsumi, Hitoshi Kitayama, Hiroyuki Sugahara, Naoki Tokita, Hironobu Nakamura, Yuzuru Kanakura, Tsunehiko Nishimura
Journal of Nuclear Medicine Apr 2001, 42 (4) 601-608;
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