[The value of positron emission tomography/computed tomography (PET/CT) in the staging of diffuse large B-cell lymphoma].
OBJECTIVE
The aim of this study was to evaluate the role of positron emission tomography/computed tomography (PET/CT) in improving the staging and changing the management of aggressive lymphoma patients in comparison with the conventional imaging modalities (CT, and 67Ga scintigraphy).


METHODS
Forty consecutive patients with diffuse large B-cell non Hodgkin lymphoma, were prospectively evaluated. All 40 patients underwent a whole body FDG PET/CT and conventional staging techniques (chest and abdomen CT, 67Ga scintigraphy) were studied before therapy. Sixty minutes after the intravenous administration of 370 MBq FDG, a whole body PET/CT was acquired. We hypothesize that PET/CT improves the diagnostic staging of lymphoma and changes the clinical management of patients.


RESULTS
PET/CT and CT were concordant in 28 patients (65%). However, PET/CT detected more lesions than CT in 11 patients (27.5%). Only in one patient, CT revealed more extensive disease than PET/CT. Additional information of PET/CT had lead to a change in staging (upstaging) in 6 patients (15%), in turn leading to a change in treatment strategy in 1 patient. PET/CT and 67Ga scintigraphy were concordant in 23 patients (60.5%). PET/CT detected more lesions than 67Ga scintigraphy in 14 patients (42%). PET/CT results changed staging (upstaging) in 4 patients (15%), leading to a change of treatment strategy in one patient.


CONCLUSIONS
The impression is that PET/CT detected more lesions than conventional examination, but this rarely translates into changes of staging and treatment strategy in aggressive lymphoma.
Fuertes
Silvia
S
Servicio de Medicina Nuclear, Hospital Clínic de Barcelona, Villaroel 170, Barcelona, Spain. sfuertes75@hotmail.com
Setoain
Xavier
X
López-Guillermo
Armando
A
Montserrat
Emilio
E
Fuster
David
D
Paredes
Pilar
P
Lomeña
Francisco
F
Pons
Francesca
F
D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016393:Lymphoma, B-Cell / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18