Utility of PET CT in management of pediatric lymphomas

Objectives Utility of PET CT in staging and restaging of lymphomas in adults is well established. The aim of this study was to analyze the utility of PET CT in pediatric lymphomas.

Methods Retrospective analysis from computerized medical records on 31 pediatric patients (age less than 18) with lymphoma referred to our center for PET CT imaging. The mean age at diagnosis was 12.45 years (19 males 12 females).The PET CT findings were correlated with diagnostic CT and clinical follow-up. The histology was 16 cases of Non Hodgkin’s lymphoma (NHL) and 15 cases of Hodgkin’s Lymphoma (HL).There were a total of 23 initial stage and 8 restaging scans.

Results For 16 scans done on the NHL subset, 11 scans were done for initial staging and 5 for restaging .10 of 11(91%) initial staging cases were concordant on both PET CT AND diagnostic CT. In 1 case PET identified disease which was not identified on the diagnostic CT.Among the 5 cases of NHL for restaging 4 of 5 showed concordance (80%).Among the 15 cases of Hodgkin’s lymphoma, there were 12 cases for initial staging and 3 cases of restaging. All these 15 cases (100%) were concordant on both PET CT and diagnostic CT.

Conclusions PET CT and diagnostic CT showed high concordance in both initial staging and restaging of pediatric lymphoma. This suggests that PET CT can be used as a single imaging modality. This high concordance suggests that the diagnostic CT can be avoided in most pediatric patients with lymphoma and thus minimizes the risk of the of radiation exposure and contrast side effects.