title: Comparison of positron emission tomography/computed tomography with classical contrast-enhanced computed tomography in the initial staging of Hodgkin lymphoma.
abstract: We compared initial computed tomography (CT) and positron emission tomography (PET)/CT in 96 patients with Hodgkin lymphoma (HL), assessing the role of baseline PET/CT in stage migration and treatment selection. The number of patients with stage I, II, III and IV disease based on CT versus PET/CT was: 5 vs. 7, 49 vs. 37, 28 vs. 22 and 14 vs. 30, respectively. In 33 (34%) patients, PET/CT changed HL stage: 27 (28%) were upstaged and six (6.3%) downstaged. Upstaging was caused by detection of new extranodal involvements (47 sites in 26 patients): bone marrow (10 patients), spleen (five patients) and lung (two patients). In nine patients≥2 further coexisting locations were detected. Downstaging resulted from the absence of fluorodeoxyglucose (18F-FDG) uptake in enlarged nodes (>15 mm) in the abdomen and pelvis. PET/CT modified HL stage in 34% of patients leading to treatment modification in the majority. Our results indicate that PET/CT should be mandatory in the initial staging of HL.
authors.affiliation: Department of Oncology and Radiotherapy, Medical University of Gdansk , Gdansk , Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Bednaruk-Młyński
authors.forename: Joanna
authors.initials: J
authors.lastname: Pieńkowska
authors.forename: Adam
authors.initials: A
authors.lastname: Skórzak
authors.forename: Bogdan
authors.initials: B
authors.lastname: Małkowski
authors.forename: Waldemar
authors.initials: W
authors.lastname: Kulikowski
authors.forename: Edyta
authors.initials: E
authors.lastname: Subocz
authors.forename: Justyna
authors.initials: J
authors.lastname: Dzietczenia
authors.forename: Marta
authors.initials: M
authors.lastname: Zalewska
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Leśniewski-Kmak
authors.forename: Renata
authors.initials: R
authors.lastname: Zaucha
authors.forename: Tomasz
authors.initials: T
authors.lastname: Wróbel
authors.forename: Jan M
authors.initials: JM
authors.lastname: Zaucha
mesh_terms: D000328:Adult; D000368:Aged; D001853:Bone Marrow / Q000378:metabolism / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006689:Hodgkin Disease / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008168:Lung / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D013154:Spleen / Q000378:metabolism / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019788:Fluorodeoxyglucose F18
keywords: Hodgkin lymphoma; PET/CT; staging