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Value of PET/CT versus PET and CT performed as separate investigations in patients with Hodgkin’s disease and non-Hodgkin’s lymphoma

European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to assess the clinical benefit of combined [18F]FDG PET/CT in patients with malignant lymphoma as compared to separately performed PET and CT.

Methods

Overall, 100 patients with Hodgkin’s disease (HD) or non-Hodgkin’s lymphoma (NHL) were included in this study. Co-registered PET/CT with [18F]FDG and contrast medium was performed in 50 consecutive patients with NHL (n=38) or HD (n=12) for initial staging (IS) (n=12) or re-treatment staging (RS) (n=38). Another 50 patients with NHL (n=32) or HD (n=18) underwent separate PET and CT investigations within a time frame of 10 days for IS (n=22) or RS (n=28). Lymphoma involvement was separately evaluated for seven different regions in each patient. Each patient had clinical follow-up evaluation for >6 months. PET and CT data were analysed separately as well as side-by-side or in fused mode.

Results

In the PET/CT group, region-based evaluation for lymphoma involvement suggested a sensitivity/specificity of 85%/91% for CT, 98%/99% for PET and 98%/99% for PET/CT. In the PET and CT group, region-based evaluation showed a sensitivity/specificity of 87%/80% for CT, 98%/99% for PET and 98%/100% for PET and CT read side by side.

Conclusion

PET was superior to CT alone and was improved further by side-by-side reading of both examinations. However, no significant difference was observed between PET/CT and separate PET and CT imaging in patients with lymphoma.

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References

  1. Hasenclever D, Diehl V. A prognostic score for advanced Hodgkin’s disease. International prognostic factors project on advanced Hodgkin’s disease. N Engl J Med 1998;339(21):1506–1514

    Article  PubMed  CAS  Google Scholar 

  2. Hicks RJ, Mac Manus MP, Seymour JF. Initial staging of lymphoma with positron emission tomography and computed tomography. Semin Nucl Med 2005;35(3):165–175

    Article  PubMed  Google Scholar 

  3. Guppy AE, Tebbutt NC, Norman A, Cunningham D. The role of surveillance CT scans in patients with diffuse large B-cell non-Hodgkin’s lymphoma. Leuk Lymphoma 2003;44(1):123–125

    Article  PubMed  CAS  Google Scholar 

  4. Canellos GP. Residual mass in lymphoma may not be residual disease. J Clin Oncol 1988;6(6):931–933

    PubMed  CAS  Google Scholar 

  5. Schiepers C, Filmont JE, Czernin J. PET for staging of Hodgkin’s disease and non-Hodgkin’s lymphoma. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S82–S88

    Article  PubMed  CAS  Google Scholar 

  6. Gambhir SS, Czernin J, Schwimmer J, Silverman DH, Coleman RE, Phelps ME. A tabulated summary of the FDG PET literature. J Nucl Med 2001;42(5 Suppl):1S–93S

    PubMed  CAS  Google Scholar 

  7. Sasaki M, Kuwabara Y, Koga H, Nakagawa M, Chen T, Kaneko K, et al. Clinical impact of whole body FDG-PET on the staging and therapeutic decision making for malignant lymphoma. Ann Nucl Med 2002;16(5):337–345

    Article  PubMed  Google Scholar 

  8. Stumpe KD, Urbinelli M, Steinert HC, Glanzmann C, Buck A, von Schulthess GK. Whole-body positron emission tomography using fluorodeoxyglucose for staging of lymphoma: effectiveness and comparison with computed tomography. Eur J Nucl Med 1998;25(7):721–728

    Article  PubMed  CAS  Google Scholar 

  9. Steinert HC. [PET/CT in lymphoma patients.]. Radiologe 2004;44(11):1060–1067

    Article  PubMed  CAS  Google Scholar 

  10. Spaepen K, Stroobants S, Verhoef G, Mortelmans L. Positron emission tomography with [18F]FDG for therapy response monitoring in lymphoma patients. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S97–S105

    Article  PubMed  Google Scholar 

  11. Weihrauch MR, Re D, Bischoff S, Dietlein M, Scheidhauer K, Krug B, et al. Whole-body positron emission tomography using 18F-fluorodeoxyglucose for initial staging of patients with Hodgkin’s disease. Ann Hematol 2002;81(1):20–25

    Article  PubMed  CAS  Google Scholar 

  12. Weihrauch MR, Dietlein M, Schicha H, Diehl V, Tesch H. Prognostic significance of 18F-fluorodeoxyglucose positron emission tomography in lymphoma. Leuk Lymphoma 2003;44(1):15–22

    Article  PubMed  Google Scholar 

  13. Wirth A, Seymour JF, Hicks RJ, Ware R, Fisher R, Prince M, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography, gallium-67 scintigraphy, and conventional staging for Hodgkin’s disease and non-Hodgkin’s lymphoma. Am J Med 2002;112(4):262–268

    Article  PubMed  Google Scholar 

  14. Kumar R, Maillard I, Schuster SJ, Alavi A. Utility of fluorodeoxyglucose-PET imaging in the management of patients with Hodgkin’s and non-Hodgkin’s lymphomas. Radiol Clin North Am 2004;42(6):1083–1100

    Article  PubMed  Google Scholar 

  15. Glazer GM, Gross BH, Quint LE, Francis IR, Bookstein FL, Orringer MB. Normal mediastinal lymph nodes: number and size according to American Thoracic Society mapping. AJR Am J Roentgenol 1985;144(2):261–265

    PubMed  CAS  Google Scholar 

  16. Lister TA, Crowther D, Sutcliffe SB, Glatstein E, Canellos GP, Young RC, et al. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J Clin Oncol 1989;7(11):1630–1636

    PubMed  CAS  Google Scholar 

  17. Freudenberg LS, Antoch G, Schutt P, Beyer T, Jentzen W, Muller SP, et al. FDG-PET/CT in re-staging of patients with lymphoma. Eur J Nucl Med Mol Imaging 2004;31(3):325–329

    Article  PubMed  CAS  Google Scholar 

  18. Schaefer NG, Hany TF, Taverna C, Seifert B, Stumpe KD, von Schulthess GK, et al. Non-Hodgkin lymphoma and Hodgkin disease: coregistered FDG PET and CT at staging and restaging—do we need contrast-enhanced CT? Radiology 2004;232(3):823–829

    PubMed  Google Scholar 

  19. Goerres GW, von Schulthess GK, Steinert HC. Why most PET of lung and head-and-neck cancer will be PET/CT. J Nucl Med 2004;45 Suppl 1:66S–71S

    PubMed  Google Scholar 

  20. Goerres GW, Stupp R, Barghouth G, Hany TF, Pestalozzi B, Dizendorf E, et al. The value of PET, CT and in-line PET/CT in patients with gastrointestinal stromal tumours: long-term outcome of treatment with imatinib mesylate. Eur J Nucl Med Mol Imaging 2005;32(2):153–162

    Article  PubMed  CAS  Google Scholar 

  21. Goerres GW, Kamel E, Seifert B, Burger C, Buck A, Hany TF, et al. Accuracy of image coregistration of pulmonary lesions in patients with non-small cell lung cancer using an integrated PET/CT system. J Nucl Med 2002;43(11):1469–1475

    PubMed  Google Scholar 

  22. Hany TF, Steinert HC, Goerres GW, Buck A, von Schulthess GK. PET diagnostic accuracy: improvement with in-line PET-CT system: initial results. Radiology 2002;225(2):575–581

    PubMed  Google Scholar 

  23. Sakai F, Sone S, Kiyono K, Maruyama A, Oguchi M, Kawai T, et al. Computed tomography of neck lymph nodes involved with malignant lymphoma: comparison with ultrasound. Radiat Med 1991;9(6):203–208

    PubMed  CAS  Google Scholar 

  24. Eisenberg PJ, Papanicolaou N, Lee MJ, Yoder IC. Diagnostic imaging in the evaluation of renal lymphoma. Leuk Lymphoma 1994;16(1–2):37–50

    Article  PubMed  CAS  Google Scholar 

  25. Bechtold RE, Karstaedt N, Wolfman NT, Glass TA. Prolonged hepatic enhancement on computed tomography in a case of hepatic lymphoma. J Comput Assist Tomogr 1985;9(1):186–189

    Article  PubMed  CAS  Google Scholar 

  26. Pombo F, Rodriguez E, Caruncho MV, Villalva C, Crespo C. CT attenuation values and enhancing characteristics of thoracoabdominal lymphomatous adenopathies. J Comput Assist Tomogr 1994;18(1):59–62

    Article  PubMed  CAS  Google Scholar 

  27. Feuerbach S, Lukas P, Gmeinwieser J. [False interpretations of computed tomograms in malignant lymph node diseases of the pelvis and abdomen]. Digitale Bilddiagn 1984;4(4):176–180

    PubMed  CAS  Google Scholar 

  28. Flecknoe-Brown S. Positron emission tomography scanning in patients with lymphoma. Intern Med J 2005;35(2):137–138

    Article  PubMed  CAS  Google Scholar 

  29. Hutchings M, Eigtved AI, Specht L. FDG-PET in the clinical management of Hodgkin lymphoma. Crit Rev Oncol Hematol 2004;52(1):19–32

    PubMed  Google Scholar 

  30. Reske SN. PET and restaging of malignant lymphoma including residual masses and relapse. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S89–S96

    Article  PubMed  Google Scholar 

  31. Dittmann H, Sokler M, Kollmannsberger C, Dohmen BM, Baumann C, Kopp A, et al. Comparison of 18FDG-PET with CT scans in the evaluation of patients with residual and recurrent Hodgkin’s lymphoma. Oncol Rep 2001;8(6):1393–1399

    PubMed  CAS  Google Scholar 

  32. Hermann S, Wormanns D, Pixberg M, Hunold A, Heindel W, Jurgens H, et al. Staging in childhood lymphoma: differences between FDG-PET and CT. Nuklearmedizin 2005;44(1):1–7

    PubMed  CAS  Google Scholar 

  33. Kazama T, Faria SC, Varavithya V, Phongkitkarun S, Ito H, Macapinlac HA. FDG PET in the evaluation of treatment for lymphoma: clinical usefulness and pitfalls. Radiographics 2005;25(1):191–207

    PubMed  Google Scholar 

  34. Moog F, Bangerter M, Diederichs CG, Guhlmann A, Merkle E, Frickhofen N, et al. Extranodal malignant lymphoma: detection with FDG PET versus CT. Radiology 1998;206(2):475–481

    PubMed  CAS  Google Scholar 

  35. Carr R, Barrington SF, Madan B, O’Doherty MJ, Saunders CA, van der Walt J, et al. Detection of lymphoma in bone marrow by whole-body positron emission tomography. Blood 1998;91(9):3340–3346

    PubMed  CAS  Google Scholar 

  36. Moog F, Kotzerke J, Reske SN. FDG PET can replace bone scintigraphy in primary staging of malignant lymphoma. J Nucl Med 1999;40(9):1407–1413

    PubMed  CAS  Google Scholar 

  37. Moog F, Bangerter M, Kotzerke J, Guhlmann A, Frickhofen N, Reske SN. 18-F-fluorodeoxyglucose-positron emission tomography as a new approach to detect lymphomatous bone marrow. J Clin Oncol 1998;16(2):603–609

    PubMed  CAS  Google Scholar 

  38. Castellucci P, Zinzani P, Pourdehnad M, Alinari L, Nanni C, Farsad M, et al. 18F-FDG PET in malignant lymphoma: significance of positive findings. Eur J Nucl Med Mol Imaging 2005;32(7):749–756

    Article  PubMed  CAS  Google Scholar 

  39. Allen-Auerbach M, Yeom K, Park J, Phelps M, Czernin J. Standard PET/CT of the chest during shallow breathing is inadequate for comprehensive staging of lung cancer. J Nucl Med 2006;47(2):298–301

    PubMed  Google Scholar 

  40. Goerres GW, Kamel E, Heidelberg TN, Schwitter MR, Burger C, von Schulthess GK. PET-CT image co-registration in the thorax: influence of respiration. Eur J Nucl Med Mol Imaging 2002;29(3):351–360

    Article  PubMed  CAS  Google Scholar 

  41. Bockisch A, Beyer T, Antoch G, Freudenberg LS, Kuhl H, Debatin JF, et al. Positron emission tomography/computed tomography—imaging protocols, artifacts, and pitfalls. Mol Imaging Biol 2004;6(4):188–199

    Article  PubMed  Google Scholar 

  42. Tatsumi M, Cohade C, Nakamoto Y, Fishman EK, Wahl RL. Direct comparison of FDG PET and CT findings in patients with lymphoma: initial experience. Radiology 2005;237(3):1038–1045

    PubMed  Google Scholar 

  43. Bar-Shalom R, Yefremov N, Guralnik L, Gaitini D, Frenkel A, Kuten A, et al. Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management. J Nucl Med 2003;44(8):1200–1209

    PubMed  Google Scholar 

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Acknowledgement

A substantial part of this work originated from the doctoral thesis of cand. med. Nicole Bröckel.

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Correspondence to Christian la Fougère.

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Christian la Fougère and Walter Hundt contributed equally to this work.

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la Fougère, C., Hundt, W., Bröckel, N. et al. Value of PET/CT versus PET and CT performed as separate investigations in patients with Hodgkin’s disease and non-Hodgkin’s lymphoma. Eur J Nucl Med Mol Imaging 33, 1417–1425 (2006). https://doi.org/10.1007/s00259-006-0171-x

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  • DOI: https://doi.org/10.1007/s00259-006-0171-x

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