Hodgkin disease: use of Tl-201 to monitor mediastinal involvement after treatment.
OBJECTIVE
To compare thallium-201 scintigraphy with gallium-67 scintigraphy in the detection of residual or recurrent mediastinal Hodgkin disease after treatment.


METHODS
The authors performed planar Ga-67 and Tl-201 scintigraphy in 39 patients aged 7-18 years (27 with mediastinal primary disease) after primary treatment. These scans and those in a control group of 14 patients with newly diagnosed known mediastinal Hodgkin disease were evaluated independently by two radiologists for abnormal mediastinal activity. Results were compared with chest computed tomographic (CT) findings and with the clinical criteria of disease status. Interobserver agreement and consensus agreement on gallium and thallium scan findings were evaluated with the kappa statistic, and the specificity of the two imaging methods was analyzed.


RESULTS
All study patients were judged to be free of mediastinal disease with CT and the clinical criteria. Interobserver agreement on findings in the treated and control patients was stronger with gallium scintigraphy (kappa +/- SD = 0.956 +/- 0.044) than with thallium scintigraphy (kappa = 0.638 +/- 0.110). Specificity of ratings based on thallium (85% +/- 6) and gallium (90% +/- 5) scintigraphic findings of mediastinal disease did not differ significantly (P = .48). Specificity improved when the results of the two examinations were combined (97% +/- 2).


CONCLUSIONS
Thallium scintigraphy can help to predict the absence of mediastinal Hodgkin disease after treatment.
Fletcher
B D
BD
Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, TN 38105, USA.
Xiong
X
X
Kauffman
W M
WM
Kaste
S C
SC
Hudson
M M
MM
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D003131:Combined Modality Therapy; D005710:Gallium Radioisotopes; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D011877:Radionuclide Imaging; D011879:Radiotherapy Dosage; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes
D005710:Gallium Radioisotopes; D013794:Thallium Radioisotopes