Abstract
Purpose
The purpose of this study was to investigate the added value of co-registered fusion imaging using a hybrid system in patients with lymphoma.
Methods
Twenty-four lymphoma patients underwent 67Ga-SPECT/CT using a hybrid tomograph consisting of a dual-head, variable-angle gamma camera and a low-dose X-ray tube. Results were compared with those of SPECT alone.
Results
Forty-five lesions were identified by SPECT alone, while 49 were detected by SPECT/CT. Forty out of the 45 lesions observed on SPECT were confirmed as lymphoma, but five were due to other causes (thoracic aorta blood pool activity, sialoadenitis in the submandibular gland, bowel activity, rib fracture and bone marrow activation due to radiotherapy). SPECT/CT identified nine more neoplastic lesions compared with SPECT alone: four areas of radiopharmaceutical accumulation were observed in para-aortic lymph nodes, three in the spleen, one in the liver and one in para-iliac lymph nodes. In five cases, SPECT/CT provided additional anatomical information over SPECT alone. In four patients, four large areas of 67Ga uptake (one mediastinal, two supraclavicular and one para-aortic) were better characterised; in one subject uptake was localised in the seventh thoracic vertebra only by SPECT/CT. Hybrid imaging provided additional data in 13 patients (54.2%), thus inducing oncologists to reconsider the therapeutic approach in eight subjects (33.2%): unnecessary treatment was avoided in four (16.6%) while therapy was altered in another four (16.6%).
Conclusion
SPECT/CT hybrid system is able to provide information not obtained by SPECT alone. It allows the anatomical localisation of lymphoma and physiological radiopharmaceutical uptake, facilitates the diagnosis of tumours located in the abdomen (subdiaphragmatic lesions) and provides information that may cause a change in therapeutic strategy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Vinnicombe SJ, Reznek RH. Computerized tomography in the staging of Hodgkin’s disease and non-Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S42–55
Rankin SC. Assessment of response to therapy using conventional imaging. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S56–64
Sapir EE, Israel O. Gallium-67 scintigraphy: a cornerstone in functional imaging of lymphoma. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S65–81
Castellani MR, Cefalo G, Terenziani M, Aliberti G, Maccauro M, Alessi A, et al. Gallium scan in adolescents and children with Hodgkin’s disease (HD): treatment response assessment and prognostic value. Q J Nucl Med 2003;47(1):22–30
Front D, Bar-Shalom R, Mor M, Haim N, Epelbaum R, Frenkel A, et al. Hodgkin disease: prediction of outcome with 67Ga scintigraphy after one cycle of chemotherapy. Radiology 1999;210:487–91
Front D, Bar-Shalom R, Mor M, Haim N, Epelbaum R, Frenkel A, et al. Aggressive non-Hodgkin lymphoma: early prediction of outcome with 67Ga scintigraphy. Radiology 2000;214:253–7
Bar-Shalom R, Mor M, Yefremov N, Goldsmith SJ. The value of Ga-67 scintigraphy and F-18 fluorodeoxyglucose positron emission tomography in staging and monitoring the response of lymphoma to treatment. Semin Nucl Med 2001;31:177–90
Kostakoglu L, Goldsmith SJ. Positron emission tomography in lymphoma: comparison with computed tomography and gallium-67 single photon emission computed tomography. Clin Lymphoma 2000;1:67–74
Chajari M, Lacroix J, Peny AM, Chesnay E, Batalla A, Henry-Amar M, et al. Gallium-67 scintigraphy in lymphoma: is there a benefit of image fusion with computed tomography? Eur J Nucl Med Mol Imaging 2002;29:380–7
Keidar Z, Israel O, Krausz Y. SPECT/CT in tumour imaging: technical aspects and clinical applications. Semin Nucl Med 2003;33 3:205–18
Israel O, Yefremov N, Mor M, Haim N, Gaitini D, Epelbaum R, et al. A new technology of combined transmission (CT) and emission (67Ga) tomography (TET) in the evaluations of patients with lymphoma (abstract). J Nucl Med 2000;41:70p
Israel O, Yefremov N, Mor M, Epelbaum R, Dann EJ, Gaitini D, et al. Combined transmission (CT) and Ga-67 emission tomography (TET) in the evaluation of response to treatment and diagnosis of recurrence in patients with lymphoma (abstract). Eur J Nucl Med 2000;27:1160
Sivolella S, Palumbo B, Palumbo I, Liberati AM, Moschini TO, Fiorucci G, et al. Usefulness of SPECT/CT with Ga-67 in evaluating patients with lymphoma (abstract). Q J Nucl Med Mol Imaging 2004;48(1):34
Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, et al. 67Ga scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging 2003;30(12):BP125–31
Schillaci O, Danieli R, Manni C, Simonetti G. Is SPECT/CT with a hybrid camera useful to improve scintigraphic imaging interpretation? Nucl Med Commun 2004;25(7):705–10
Schillaci O. Functional–anatomical image fusion in neuroendocrine tumors. Cancer Biother Radiopharm 2004;19(1):129–34
Schillaci O, Danieli R, Manni C, Capoccetti F, Simonetti G. Technetium-99m-labelled red blood cell imaging in the diagnosis of hepatic haemangiomas: the role of SPECT/CT with a hybrid camera. Eur J Nucl Med Mol Imaging 2004;31:1011–5
Tharp K, Israel O, Hausmann J, Bettman L, Martin WH, Daitzchman M, et al. Impact of 131I-SPECT/CT images obtained with an integrated system in the follow-up of patients with thyroid carcinoma. Eur J Nucl Med Mol Imaging 2004;31:1435–42
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Palumbo, B., Sivolella, S., Palumbo, I. et al. 67Ga-SPECT/CT with a hybrid system in the clinical management of lymphoma. Eur J Nucl Med Mol Imaging 32, 1011–1017 (2005). https://doi.org/10.1007/s00259-005-1788-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00259-005-1788-x