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Role of whole-body [18F] fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and conventional techniques in the staging of patients with Hodgkin and aggressive non Hodgkin lymphoma

Stadiazione dei linfomi di Hodgkin e dei linfomi non-Hodgkin aggressivi: ruolo dell’esame PET/TC total body con 18F-fluorodesossiglucosio e confronto con le tecniche convenzionali di stadiazione

  • Abdominal Radiology/Radiologia Addominale
  • Published:
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Abstract

Purpose

The aim of this study was to evaluate the role of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in the staging of Hodgkin’s and aggressive non-Hodgkin’s lymphoma (HL and NHL), comparing it with conventional diagnostic methods, i.e. contrast-enhanced CT and bone marrow biopsy.

Materials and methods

Sixty-five consecutive patients (30 HL and 35 NHL) who underwent conventional disease staging and FDG-PET/CT were included. Concordance between conventional methods and PET was established when both procedures identified the same disease stage. Discordant findings were investigated further by using other diagnostic techniques (ultrasonography or magnetic resonance imaging) and/or clinical follow-up.

Results

PET correctly staged 93.8% of enrolled patients (61/65), whereas conventional techniques correctly staged 89.2% (58/65; p=NS, gC2 test). There was complete concordance in 54/65 patients (83.1%); among the remaining 11 cases, PET upstaged eight patients (seven true positive and one false positive), and downstaged three (all false negative). In 5/65 patients, chemotherapy treatment was modified on the basis of PET findings.

Conclusions

Our data confirm the high accuracy of FDG-PET/CT in staging HL and NHL. FDG-PET/CT should therefore be used routinely in the initial evaluation of both patient subgroups.

Riassunto

Obiettivo

Scopo di questo studio è stato quello di valutare il ruolo dell’esame PET/TC total body con 18F-fluorodesossiglucosio (FDG-PET/TC) nella stadiazione dei linfomi di Hodgkin (LH) e non-Hodgkin aggressivi (NHL), confrontandolo con le tecniche convenzionali di stadiazione (TC con mezzo di contrasto e biopsia osteo-midollare).

Materiali e metodi

Sono stati inclusi 65 pazienti consecutivi (30 LH e 35 NHL) che hanno eseguito stadiazione convenzionale e FDG-PET/TC. Le due procedure sono state definite concordanti quando entrambe hanno identificato il medesimo stadio di malattia; in caso di discordanza sono state eseguiti altri esami (ecografia o risonanza magnetica) e/o follow-up clinico.

Risultati

L’esame PET ha consentito di stadiare correttamente 61/65 pazienti (93,8%), le metodiche convenzionali 58/65 (89,2%; p=ns, test gC2). Nella stadiazione, entrambe le tecniche risultavano concordare in 54/65 casi (83,1%); nei restanti 11 casi, l’esame PET ha determinato una sovrastadiazione in 8 pazienti (7 veri positivi ed 1 falso positivo) e una sotto-stadiazione in 3 casi (tutti falsi negativi). Sulla base dei risultati PET il trattamento chemioterapico è stato modificato in 5 pazienti.

Conclusioni

I nostri dati confermano l’elevata accuratezza diagnostica dell’esame FDG-PET/TC nella stadiazione dei LH e LNH. Questo ne suggerisce un uso di routine nell’iter di stadiazione.

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Authors and Affiliations

  1. SCDU Medicina Nucleare, ASO S. Giovanni Battista, Torino, Italy

    E. Pelosi, D. Penna, D. Deandreis & G. Bisi

  2. Centro PET IRMET SpA, Torino, Italy

    E. Pelosi & M. Mancini

  3. SCDO Ematologia, ASO S. Giovanni Battista, Torino, Italy

    P. Pregno, A. Chiappella, U. Vitolo & E. Gallo

  4. SCDO Radiologia, ASO S. Giovanni Battista, Torino, Italy

    G. Limerutti

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  1. E. Pelosi
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  2. P. Pregno
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Pelosi, E., Pregno, P., Penna, D. et al. Role of whole-body [18F] fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and conventional techniques in the staging of patients with Hodgkin and aggressive non Hodgkin lymphoma. radiol med 113, 578–590 (2008). https://doi.org/10.1007/s11547-008-0264-7

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  • DOI: https://doi.org/10.1007/s11547-008-0264-7

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