Coincidence-detection FDG-PET versus gallium in children and young adults with newly diagnosed Hodgkin's disease.
Coincidence-detection 18F-FDG-PET (PET) and 67Ga whole-body and SPECT (Ga) were compared in children and young adults with newly diagnosed Hodgkin's disease (HD).


METHODS
Thirty patients with histologically confirmed HD underwent PET with attenuation correction 1 h after injection of 150-220 MBq 18F-FDG and whole-body and SPECT imaging 72 h after injection of 250-370 MBq 67Ga citrate. Two experienced readers retrospectively reviewed PET and Ga scans, grading 13 anatomic regions from one (normal) to five (abnormal). Numerical stages were assigned based on Ann Arbor classification. Comparison was made with disease sites (established by biopsy or two or more of the following: physical examination, conventional imaging studies, radionuclide studies, and follow-up studies) and clinical stages. Sensitivity, specificity, and accuracy were calculated and significance of differences determined using McNemar's test.


RESULTS
PET detected 120/138 (87%) disease sites and Ga 109/138 (79%). PET and Ga were concordant for 103/138 (75%) sites. Accuracies were not significantly different for supradiaphragmatic disease. PET was more accurate than Ga for detecting splenic (0.91 vs 0.61, P = 0.012), infradiaphragmatic (0.89 vs 0.75, P = 0.042), and all disease sites combined (0.95 vs 0.91, P = 0.039). PET stage agreed with clinical stage in 79% of patients and Ga in 71%.


CONCLUSIONS
PET was superior to Ga for evaluating children and young adults with newly diagnosed HD.
Rini
Josephine N
JN
Division of Nuclear Medicine, Long Island Jewish Medical Center, 270-05 76th Avenue, New Hyde Park, NY 11040, USA rini@LIJ.edu
Núñez
Rodolfo
R
Nichols
Kenneth
K
Tronco
Gene G
GG
Tomas
Maria Bernadette
MB
Hart
Diane
D
Karayalcin
Gungor
G
Leonidas
John C
JC
Palestro
Christopher J
CJ
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005189:False Positive Reactions; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D005710:Gallium Radioisotopes / Q000493:pharmacokinetics; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D012372:ROC Curve; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology; D015899:Tomography, Emission-Computed, Single-Photon
D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18