Annals of Nuclear Medicine

, Volume 16, Issue 5, pp 337–345

Clinical impact of whole body FDG-PET on the staging and therapeutic decision making for malignant lymphoma

  • Masayuki Sasaki
  • Yasuo Kuwabara
  • Hirofumi Koga
  • Makoto Nakagawa
  • Tao Chen
  • Kouichirou Kaneko
  • Kazutaka Hayashi
  • Katsumasa Nakamura
  • Kouji Masuda
Original Articles

DOI: 10.1007/BF02988618

Cite this article as:
Sasaki, M., Kuwabara, Y., Koga, H. et al. Ann Nucl Med (2002) 16: 337. doi:10.1007/BF02988618

Abstract

Objectives: The aim of this study is to evaluate the clinical impact of whole-body FDG-PET for the pre-therapeutic evaluation of malignant lymphoma and compared to that of 67Ga-scintigraphy when added to non-RI examinations. Methods: We examined 46 patients with malignant lymphoma including 42 newly diagnosed cases and 4 relapsed cases. Whole-body FDG-PET was started 63 minutes after the administration of FDG with ECATEXACT HR+. The clinical stage of each patient was determined based on the results of a non-RI examination (consisting of physical examination, CT, gastrointestinal studies and bone marrow aspiration), 67Ga planar images and FDG-PET. Discrepant findings were verified based on the response to treatment and the findings of a follow-up examination more than 6 months after treatment. Finally, 152 nodal regions and 19 extranodal tissues were found to be involved by disease. Results: In the 152 nodal lesions, FDG-PET detected 54 nodal lesions in addition to 98 lesions detected by non-RI examinations, whereas 67Ga-scintigraphy detected 14 additional lesions. The sensitivity of non-RI, non-RI+67Ga and non-RI+FDG was 64.5%, 73.7% and 100.0%, respectively. In 19 extranodal lesions, FDG-PET detected 5 extranodal lesions in addition to 13 lesions detected by non-RI examinations, whereas 67Ga-scintigraphy detected 1 additional lesion. The sensitivity of non-RI, non-RI+67Ga and non-RI+FDG was 68.4%, 73.7% and 94.7%, respectively. When combining the FDG-PET findings with the non-RI findings, the improvement of the detectability was much higher than that when 67Ga findings were combined to the non-RI findings. For the staging of lymphoma, the non-RI and non-RI+67Ga findings accurately diagnosed 76.1% and 80.4%, respectively, whereas the non-RI+FDG findings accurately diagnosed 82.6%. Finally, FDG-PET resulted in changes in the clinical management of 8 patients (17.4%). Conclusions: FDG-PET offers more information in addition to the findings of conventional diagnostic methods than 67Ga-scintigraphy in order to accurately detect malignant lymphoma. FDG-PET can therefore play an important role in therapeutic decision making on lymphoma.

Key words

malignant lymphomaFDG (18F-fluorodeoxyglucose)PET (positron emission tomography)stagingmanagement

Copyright information

© Springer 2002

Authors and Affiliations

  • Masayuki Sasaki
    • 1
  • Yasuo Kuwabara
    • 1
  • Hirofumi Koga
    • 1
  • Makoto Nakagawa
    • 1
  • Tao Chen
    • 1
  • Kouichirou Kaneko
    • 1
  • Kazutaka Hayashi
    • 1
  • Katsumasa Nakamura
    • 1
  • Kouji Masuda
    • 1
  1. 1.Department of Clinical Radiology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan