(18)F-FDG PET and conventional imaging for assessment of Hodgkin's disease and non Hodgkin's lymphoma. An analysis of 193 patient studies.
The AIM of this study was to assess the diagnostic value of FDG-PET and conventional imaging (CI) in a large series of patient with Hodgkin's disease (HD) or non-Hodgkin's lymphoma (NHL) at three time points during their course of disease.


METHODS
169 consecutive lymphoma patients (69 HD; 100 NHL) were included. 193 FDG-PET studies were performed for staging at baseline in 42 cases, for post-therapeutic monitoring in 103, and for diagnosis of recurrence in 48 cases. Performance indices of sensitivity, specificity, positive (PPV) and negative predictive value (NPV), and accuracy of metabolic FDG-PET and morphological CI were calculated. Differences in staging and diagnosis of residual or recurrent lymphoma were compared.


RESULTS
FDG-PET changed staging in 36% of cases for staging at baseline, in 52% of cases for monitoring response to treatment, and in 29% for diagnosis of recurrence. FDG-PET staging results were confirmed in 80% for staging at baseline, in 74% for monitoring response to treatment, and in 50% for diagnosis of recurrence. FDGPET and CI differed significantly at monitoring response to treatment for sensitivity (0.91 versus 0.69; p < 0.02), specificity (0.90 versus 0.38; p < 0.00001), PPV (0.77 versus 0.42; p < 0.001), and accuracy (0.83 versus 0.55; p < 0.02).


CONCLUSIONS
FDG-PET should be considered as the diagnostic modality of choice for post-therapeutic assessment of lymphoma patients and may be a reliable alternative to CI for staging at baseline and diagnosis of recurrence.
Bucerius
J
J
Department of Nuclear Medicine, University Hospital of Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. jan.bucerius@ukb.uni-bonn.de
Herkel
C
C
Joe
A Y
AY
Altehoefer
C
C
Finke
J
J
Moser
E
E
Reinhardt
M J
MJ
D000328:Adult; D005260:Female; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000000981:diagnostic imaging*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18