title: Limited positron emission tomography-computed tomography for restaging of lymphoma: a strategy for reducing radiation exposure among patients with early-stage curable lymphoma.
abstract: Repeated imaging with positron emission tomography-computed tomography (PET-CT) is associated with cumulative exposure to substantial doses of radiation. Furthermore, PET-CT is an expensive and limited resource in many institutions. We conducted a retrospective analysis to evaluate whether limited PET-CT focused on the initially involved field of view (FOV) at diagnosis, corresponding to an above- or below-the-diaphragm scan, is sufficient for follow-up of patients with Hodgkin (HL) and aggressive non-Hodgkin lymphoma (NHL). One hundred thirty-one examinations of 44 patients with early-stage (I-II) HL (n = 27) and aggressive NHL (n = 17) who had PET-CT performed as part of their initial staging and at follow-up were analyzed. Regardless of the extent of response to treatment, there was no single case in which the disease progressed outside of the initially involved FOV (0/44, 95% CI 0-0.08). This was true even in cases of disease progression, including in the setting of relapse. Our findings suggest that limited PET-CT analysis of the initially involved FOV in patients with early-stage curable lymphoma may be satisfactory for response assessment.
authors.affiliation: Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center-Beilinson Hospital, Petah Tikva, Israel.
authors.forename: Ofir
authors.initials: O
authors.lastname: Wolach
authors.forename: Hanna
authors.initials: H
authors.lastname: Bernstine
authors.forename: Yonatan
authors.initials: Y
authors.lastname: Edel
authors.forename: Osnat
authors.initials: O
authors.lastname: Bairey
authors.forename: Ofer
authors.initials: O
authors.lastname: Shpilberg
authors.forename: David
authors.initials: D
authors.lastname: Groshar
authors.forename: Meir
authors.initials: M
authors.lastname: Lahav
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000009:adverse effects; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000009:adverse effects; D011379:Prognosis; D011832:Radiation Injuries / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D019275:Radiopharmaceuticals / Q000009:adverse effects*; D012074:Remission Induction; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000009:adverse effects; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18