F-18 FDG-PET imaging and correlation with CT in staging and follow-up of pediatric lymphomas.
BACKGROUND
We hypothesized that F-18 FDG-PET could be a useful, functional imaging modality for assessing the initial staging, response to therapy and follow-up of children diagnosed with lymphoma.


OBJECTIVE
To assess the role of whole-body F-18 FDG-PET imaging in patients with lymphoma as an initial staging modality and to measure its predictive value for monitoring the response to therapy and disease recurrence compared to CT and clinical follow-up studies.


METHODS
As part of their routine clinical care, 24 patients with histologically proven lymphoma (18 Hodgkin disease and 6 non-Hodgkin lymphoma) underwent an F-18 FDG-PET and a CT scan. A total of 28 studies were performed and the entire set of scans retrospectively reviewed. Seven studies were performed for initial staging, 12 for monitoring therapy response and 9 for detecting recurrence. Initial diagnosis was confirmed by histopathology while the gold standard at follow-up was established by clinical follow-up, additional imaging modalities and/or biopsy. F-18 FDG-PET was visually compared to CT on a lesion-by-lesion basis. Fifteen anatomic regions (seven nodal and eight extranodal) were analyzed.


RESULTS
Of the 414 regions analyzed, PET and CT were concordant in 366 (positive in 16 and negative in 350). Discordance was found in 48 regions. Overall sensitivities, specificities, and positive and negative predictive values were 78%, 98%, 94% and 90% for F-18 FDG-PET and 79%, 88%, 90% and 46% for CT, respectively.


CONCLUSIONS
F-18 FDG-PET imaging is a useful technique for the staging and follow-up of pediatric patients with lymphoma.
Hernandez-Pampaloni
Miguel
M
Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Takalkar
Amol
A
Yu
Jian Q
JQ
Zhuang
Hongming
H
Alavi
Abass
A
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18