TY - JOUR
T1 - Clinical impact of whole body FDG-PET on the staging and therapeutic decision making for malignant lymphoma
AU - Sasaki, Masayuki
AU - Kuwabara, Yasuo
AU - Koga, Hirofumi
AU - Nakagawa, Makoto
AU - Chen, Tao
AU - Kaneko, Kouichirou
AU - Hayashi, Kazutaka
AU - Nakamura, Katsumasa
AU - Masuda, Kouji
PY - 2002/7
Y1 - 2002/7
N2 - 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 ECAT EXACT 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 67Gascintigraphy 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 67Gascintigraphy 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.
AB - 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 ECAT EXACT 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 67Gascintigraphy 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 67Gascintigraphy 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.
UR - http://www.scopus.com/inward/record.url?scp=0036655324&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036655324&partnerID=8YFLogxK
U2 - 10.1007/BF02988618
DO - 10.1007/BF02988618
M3 - Article
C2 - 12230093
AN - SCOPUS:0036655324
SN - 0914-7187
VL - 16
SP - 337
EP - 345
JO - Annals of Nuclear Medicine
JF - Annals of Nuclear Medicine
IS - 5
ER -