title: Abdomen/pelvis computed tomography in staging of pediatric Hodgkin Lymphoma: is it always necessary?
abstract: The purpose of the study was to determine if abdomen/pelvis computed tomography (CT) can be safety omitted in the initial staging of a subgroup of children affected by Hodgkin Lymphoma (HL). Every participating center of A.I.E.O.P (Associazione Italiana di Ematologia ed Oncologia Pediatrica) sent local staging reports of 18F-fluorodeoxyglucose positron emission tomography (PET) and abdominal ultrasound (US) along with digital images of staging abdomen/pelvis CT to the investigation center where the CT scans were evaluated by an experienced pediatric radiologist. The local radiologist who performed the US was unaware of local CT and PET reports (both carried out after US), and the reviewer radiologist examining the CT images was unaware of local US, PET and CT reports. A new abdominal staging of 123 patients performed on the basis of local US report, local PET report, and centralized CT report was then compared to a simpler staging based on local US and PET. No additional lesion was discovered by CT in patients with abdomen/pelvis negativity in both US and PET or isolated spleen positivity in US (or US and PET), and so it seems that in the initial staging, abdomen/pelvis CT can be safety omitted in about 1/2 to 2/3 of children diagnosed with HL.
authors.affiliation: Pediatric Hematology and Oncology Unit, Oncology Department, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy. piero.farruggia@arnascivico.it, pfarruggia@libero.it.
authors.forename: Piero
authors.initials: P
authors.lastname: Farruggia
authors.affiliation: Department of Sciences for Health Promotion and Mother and Child Care, University of Palermo, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Puccio
authors.affiliation: Clinica Pediatrica, Universita' Milano - Bicocca, A.O. San Gerardo, Fondazione Monza e Brianza per il bambino e la sua mamma (MBBM), Monza, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sala
authors.affiliation: Dipartimento di Oncoematologia Pediatrica, Università di Padova, Padova, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Todesco
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Terenziani
authors.affiliation: Pediatric Hematology-Oncology, Ospedale Pediatrico Microcitemico, Cagliari, Italy.
authors.forename: Rosamaria
authors.initials: R
authors.lastname: Mura
authors.affiliation: Oncologia Pediatrica, Clinica Pediatrica, Catania, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: D'Amico
authors.affiliation: Dipartimento di Oncoematologia Pediatrica, A.O.U Meyer, Firenze, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Casini
authors.affiliation: Pediatric Hematology and Oncology Unit, Oncology Department, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy.
authors.forename: Clara
authors.initials: C
authors.lastname: Mosa
authors.affiliation: Dipartimento di Oncoematologia Pediatrica, Università di Padova, Padova, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Pillon
authors.affiliation: Dipartimento di Oncoematologia Pediatrica, Università di Padova, Padova, Italy.
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Boaro
authors.affiliation: Dipartimento di Pediatria II Ateneo di Napoli, Servizio di Oncologia Pediatrica, Napoli, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Bottigliero
authors.affiliation: Oncoematologia Pediatrica, Azienda Ospedaliera Universitaria, Ospedale Sant'Anna, Ferrara, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Burnelli
authors.affiliation: Pediatric Hemato-oncology Unit, Dipartimento di Onco-Ematologia, Catanzaro Hospital, Catanzaro, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Consarino
authors.affiliation: Department of Pediatrics, Niguarda Ca' Granda Hospital, Milano, Italy.
authors.forename: Fausto
authors.initials: F
authors.lastname: Fedeli
authors.affiliation: S.S. Radioterapia Pediatrica e Area Giovani, IRCCS, Centro di Riferimento Oncologico Aviano, Pordenone, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Mascarin
authors.affiliation: Oncoematologia Pediatrica, Azienda Ospedaliera-Universitaria di Perugia, Perugia, Italy.
authors.forename: Katia
authors.initials: K
authors.lastname: Perruccio
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Schiavello
authors.affiliation: Pediatric Hematology and Oncology Unit, Oncology Department, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Trizzino
authors.affiliation: Dipartimento Oncologico La Maddalena, Medicina Nucleare, Palermo, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Ficola
authors.affiliation: Dipartimento di Ematologia e Oncologia Pediatrica Istituto G. Gaslini, Genova, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Garaventa
authors.affiliation: Radiology Unit, Radiology Department, A.R.N.A.S. Ospedali Civico, Di Cristina e Benfratelli, Palermo, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Rossello
mesh_terms: D000005:Abdomen / Q000473:pathology*; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D010388:Pelvis / Q000473:pathology*; D000072078:Positron Emission Tomography Computed Tomography; D049268:Positron-Emission Tomography; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Childhood; Hodgkin Lymphoma; PET