FDG PET can replace bone scintigraphy in primary staging of malignant lymphoma.
Recent studies indicated that 18F-fluorodeoxyglucose (FDG) PET may be more accurate than CT in staging nodal and extranodal malignant lymphoma. The objective of this study was to compare conventional bone scintigraphy as an established skeletal staging procedure with PET using FDG in the detection of osseous involvement in malignant lymphoma.


METHODS
Whole-body PET-based staging studies of 56 consecutive patients with proven Hodgkin's disease (n = 34) or non-Hodgkin's lymphoma (n = 22) were compared with the results of bone scintigraphy. Positive PET or bone scintigraphic findings were confirmed, if possible, by biopsy, MRI, CT or radiographic investigations.


RESULTS
Of the 56 patients studied, 12 were found to have skeletal involvement on both studies (PET, 30 regions; bone scintigraphy, 20 regions). Findings were confirmed in all 12 patients. FDG PET detected an additional 12 involved regions in 5 patients. This was subsequently verified in 3 patients, although the other 2 cases remained unresolved. Conversely, bone scintigraphy revealed five abnormalities compatible with lymphoma in 5 patients. Three of these lesions were found to be erroneous; final evaluation of the remaining two findings was not possible.


CONCLUSIONS
FDG PET is suitable for identifying osseous involvement in malignant lymphoma with a high positive predictive value and is thereby more sensitive and specific than bone scintigraphy.
Moog
F
F
Department of Nuclear Medicine, University of Ulm, Germany.
Kotzerke
J
J
Reske
S N
SN
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D001859:Bone Neoplasms / Q000000981:diagnostic imaging*; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18