Hodgkin disease: prediction of outcome with 67Ga scintigraphy after one cycle of chemotherapy.
OBJECTIVE
To investigate gallium 67 scintigraphy performed early during treatment as a means to predict outcome and thus to optimize treatment of Hodgkin disease (HD) in the future.


METHODS
Ninety-eight patients with HD were examined. Thirty-one patients underwent 67Ga scintigraphy after one chemotherapy cycle and 83 patients after a mean 3.5 cycles (range, 2-5 cycles). Sixteen patients underwent 67Ga scintigraphy both after one cycle and at midtreatment. Patients underwent whole-body scintigraphy and single photon emission computed tomography of the torso. Torso computed tomography (CT) was performed after a mean 3.5 cycles (range, 2-6 cycles). Failure-free survival was compared between patients with positive and patients with negative test findings (Kaplan-Meier method), and the significance of the difference was calculated. The association of failure-free survival with various prognostic clinical factors before treatment was compared (log-rank test univariate analysis).


RESULTS
Failure-free survival differed significantly (P < .002) between patients with positive and patients with negative 67Ga scintigrams after one chemotherapy cycle but not at midtreatment. Failure-free survival was not significantly different between patients with positive and patients with negative CT scans at midtreatment. Twenty-two (92%) of 24 patients with negative 67Ga scintigrams after one cycle and 64 (82%) of 78 patients with negative scintigrams at midtreatment remained in complete response. In four (57%) of seven patients with positive 67Ga scintigrams after one cycle, treatment failed.


CONCLUSIONS
67Ga scintigraphy after one cycle of chemotherapy is a good early predictor of outcome of HD.
Front
D
D
Department of Nuclear Medicine, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.
Bar-Shalom
R
R
Mor
M
M
Haim
N
N
Epelbaum
R
R
Frenkel
A
A
Gaitini
D
D
Kolodny
G M
GM
Israel
O
O
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D005710:Gallium Radioisotopes; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D015996:Survival Rate; D016896:Treatment Outcome
D005710:Gallium Radioisotopes