Skip to main content
SpringerLink
Log in

PET imaging in pediatric Hodgkin’s lymphoma

  • Minisymposium
  • Published:
Pediatric Radiology Aims and scope Submit manuscript

Abstract

Advances in diagnostic imaging technology, especially functional imaging modalities like positron emission tomography (PET), have significantly influenced the staging and treatment approaches used for pediatric Hodgkin’s lymphoma. Today, the majority of children and adolescents diagnosed with Hodgkin’s lymphoma will be cured following treatment with non-cross-resistant combination chemotherapy alone or in combination with low-dose, involved-field radiation. This success produced a greater appreciation of long-term complications related to radiation, chemotherapy, and surgical staging that prompted significant changes in staging and treatment protocols for children and adolescents with Hodgkin’s lymphoma. Contemporary treatment for pediatric Hodgkin’s lymphoma uses a risk-adapted approach that reduces the number of combination chemotherapy cycles and radiation treatment fields and doses for patients with localized favorable disease presentation. Advances in diagnostic imaging technology have played a critical role in the development of these risk-adapted treatment regimens. The introduction of computed tomography (CT) provided an accurate and non-invasive modality to define nodal involvement below the diaphragm that motivated the change from surgical to clinical staging. The introduction of functional imaging modalities, like positron emission tomography (PET) scanning, provided the means to correlate tumor activity with anatomic features generated by CT and modify treatment based on tumor response. For centers with access to this modality, PET imaging plays an important role in staging, evaluating tumor response, planning radiation treatment fields, and monitoring after completion of therapy for pediatric Hodgkin’s lymphoma. This trend will likely increase in the future as a result of PET’s superior sensitivity in correlating sites of tumor activity compared to other available functional imaging modalities. Ongoing prospective studies of PET in pediatric patients will increase understanding about the optimal use of this modality in children with cancer and define the characteristics of FDG-avid nonmalignant conditions that may be problematic in the interpretation of tumor activity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.
Fig. 3.
Fig. 4.
Fig. 5.

Similar content being viewed by others

References

  1. Hudson MM, Donaldson SS (1999) Treatment of pediatric Hodgkin’s lymphoma. Semin Hematol 36:313–323

    CAS  PubMed  Google Scholar 

  2. Hudson MM, Donaldson SS (2002) Hodgkin’s disease. In: Pizzo PA, Poplack DG (eds) Principles and practice of pediatric oncology, 4th edn. Lippincott, Williams & Wilkins, Philadelphia, pp 637–660

  3. Hudson MM, Poquette CA, Lee J, et al (1998) Increased mortality after successful treatment of Hodgkin’s disease. J Clin Oncol 16:3592–3600

    CAS  PubMed  Google Scholar 

  4. Hudson MM (2003) Pediatric Hodgkin’s therapy: time for a paradigm shift. J Clin Oncol 20:3755–3757

    Google Scholar 

  5. Castellino RA, Blank N, Hoppe RT, et al (1986) Hodgkin’s disease: contributions of chest CT in the initial staging evaluation. Radiology 160:603–605

    CAS  PubMed  Google Scholar 

  6. Rostock RA, Giangreco A, Wharam MD, et al (1982) CT scan modification in the treatment of mediastinal Hodgkin’s disease. Cancer 49:2267–2275

    CAS  PubMed  Google Scholar 

  7. Hanna SL, Fletcher BD, Boulden TF, et al (1993) MR imaging of infradiaphragmatic lymphadenopathy in children and adolescents with Hodgkin disease: comparison with lymphography and CT. J Magn Reson Imaging. 3:461–470

    Google Scholar 

  8. Weiner M, Leventhal B, Cantor A, et al (1991) Gallium-67 scans as an adjunct to computed tomography scans for the assessment of a residual mediastinal mass in pediatric patients with Hodgkin’s disease. A Pediatric Oncology Group study. Cancer 68:2478–2480

    CAS  PubMed  Google Scholar 

  9. Brisse H, Pacquement H, Burdairon E, et al (1998) Outcome of residual mediastinal masses of thoracic lymphomas in children: impact on management and radiological follow-up strategy. Pediatr Radiol 28:444–450

    Article  CAS  PubMed  Google Scholar 

  10. Luker GD, Siegel MJ (1993) Mediastinal Hodgkin disease in children: response to therapy. Radiology 189:737–740

    PubMed  Google Scholar 

  11. Bar-Shalom R, Valdivia AY, Blaufox MD (2000) PET imaging in oncology. Semin Nucl Med 30:150–185

    CAS  PubMed  Google Scholar 

  12. Bar-Shalom R, Yefremov N, Haim N, et al (2003) Camera-based FDG PET and 67 Ga SPECT in evaluation of lymphoma: comparative study. Radiology 227:353–360

    PubMed  Google Scholar 

  13. Hueltenschmidt B, Sautter-Bihl ML, Lang O, et al (2001) Whole body positron emission tomography in the treatment of Hodgkin disease. Cancer 91:302–310

    Article  CAS  PubMed  Google Scholar 

  14. Shulkin BL (1997) PET applications in pediatrics. Q J Nucl Med 41:281–291

    CAS  PubMed  Google Scholar 

  15. Jerusalem G, Beguin Y, Fassotte MF, et al (1999) Whole-body positron emission tomography using 18F-fluorodeoxyglucose for posttreatment evaluation in Hodgkin’s disease and non-Hodgkin’s lymphoma has higher diagnostic and prognostic value than classical computed tomography scan imaging. Blood 94:429–433

    CAS  PubMed  Google Scholar 

  16. Wirth A, Seymour JF, Hicks RJ, et al (2002) Fluorine-18 fluorodeoxyglucose positron emission tomography, gallium-67 scintigraphy, and conventional staging for Hodgkin’s disease and non-Hodgkin’s lymphoma. Am J Med 112:262–268

    Article  PubMed  Google Scholar 

  17. Bangerter M, Kotzerke J, Griesshammer M, et al (1999) Positron emission tomography with 18-fluorodeoxyglucose in the staging and follow-up of lymphoma of the chest. Acta Oncol 38:799–804

    CAS  PubMed  Google Scholar 

  18. James K, Eisenhauer E, Christian M, et al (1999) Measuring response in solid tumors: unidimensional versus bidimensional measurement. J Natl Cancer Inst 91:523–528

    Article  CAS  PubMed  Google Scholar 

  19. Therasse P, Arbuck SG, Eisenhauer EA, et al (2000) New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst 92:205–216

    CAS  PubMed  Google Scholar 

  20. Langer CJ, Keller SM, Erner SM (1992) Thymic hyperplasia with hemorrhage simulating recurrent Hodgkin disease after chemotherapy-induced complete remission. Cancer 70:2082–2086

    CAS  PubMed  Google Scholar 

  21. Osborne BM, Butler JJ, Gresik MV (1992) Progressive transformation of germinal centers: comparison of 23 pediatric patients to the adult population. Mod Pathol 5:135–140

    CAS  PubMed  Google Scholar 

  22. Nguyen PL, Ferry JA, Harris NL (1999) Progressive transformation of germinal centers and nodular lymphocyte predominant Hodgkin’s disease: a comparative immunohistochemical study. Am J Surg Pathol 23:27–33

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Hematology-Oncology, St. Jude Children’s Research Hospital, 332 N. Lauderdale, Memphis, TN 38105, USA

    Melissa M. Hudson

  2. Department of Radiological Sciences, Division of Radiation Oncology, St. Jude Children’s Research Hospital, 332 N. Lauderdale, Memphis, TN 38105, USA

    Matthew J. Krasin

  3. Department of Radiological Sciences, Division of Diagnostic Imaging, St. Jude Children’s Research Hospital, 332 N. Lauderdale, Memphis, TN 38105, USA

    Sue C. Kaste

  4. Department of Radiology, College of Medicine, University of Tennessee Health Science Center, 800 Madison Avenue, Memphis, TN 38163, USA

    Sue C. Kaste

Authors
  1. Melissa M. Hudson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Matthew J. Krasin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sue C. Kaste
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Melissa M. Hudson.

Additional information

Supported in part by grants Cancer Center Support (CORE) Grant CA-21765, P01 CA-20180 from the National Cancer Institute from the National Institutes of Health, a Center of Excellence grant from the state of Tennessee, and by the American Lebanese Syrian Associated Charities (ALSAC)

CME activity Please find the CME information and questions at the end of this issue

The author(s) have no financial interest, arrangement, or affiliation to disclose in the context of this CME activity. There is nothing to disclose regarding investigational or “off-label” use of medical devices or other products, or any pharmaceutical agents

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hudson, M.M., Krasin, M.J. & Kaste, S.C. PET imaging in pediatric Hodgkin’s lymphoma. Pediatr Radiol 34, 190–198 (2004). https://doi.org/10.1007/s00247-003-1114-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00247-003-1114-3

Keywords

Search

Navigation