The role of high dose 67-gallium scintigraphy in staging untreated patients with lymphoma.
BACKGROUND
Gallium-67 (67Ga) scintigraphy has been reported to be of limited value in staging lymphoma patients. However, recent technical advances in radionuclide imaging have potentially enhanced the usefulness of this method.


OBJECTIVE
The purposes of this study were to determine the current: (1) sensitivity and specificity and (2) impact on clinicians' treatment decisions of 67Ga scans performed at a teaching hospital.


METHODS
There were 46 newly presenting patients with lymphoma (13 with Hodgkin's disease (HD) and 33 with non-Hodgkin's lymphoma [NHL]). Planar 67Ga scans were performed up to eight days following injection of 300 MBq (8 mCi) with images interpreted by consensus of two blinded observers; sensitivity and specificity were determined on a lesion by lesion basis in comparison to computed tomography (CT) scans, palpation of peripheral lymph nodes and abdominal lymphangiograms (n = 5). The contribution of 67Ga scans to clinicians' treatment decisions was also independently assessed by an experienced oncologist.


RESULTS
Gallium-67 scan sensitivity and specificity were 80% and 96% for HD and 59% and 98% for NHL. Initial treatment plans were modified in three individuals (7%; 95% confidence intervals = 3-10%) due to lesions on the 67Ga scan not prospectively detected or considered equivocal on other tests.


CONCLUSIONS
Only a small proportion of newly diagnosed lymphoma patients benefit from staging with state of the art planar high dose 67Ga imaging.
Larcos
G
G
Department of Nuclear Medicine, Westmead Hospital, Sydney, NSW.
Farlow
D C
DC
Antico
V F
VF
Gruenewald
S M
SM
Boyages
J
J
D000328:Adult; D002985:Clinical Protocols; D005260:Female; D005710:Gallium Radioisotopes; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D005710:Gallium Radioisotopes