E-ISSN: 1305-3612
Fluorine-18 fluorodeoxyglucose PET-CT for extranodal staging of non-Hodgkin and Hodgkin lymphoma
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Nuclear Medicine and Molecular Imaging - Original Article
VOLUME: 20 ISSUE: 2
P: 185-192
March 2014

Fluorine-18 fluorodeoxyglucose PET-CT for extranodal staging of non-Hodgkin and Hodgkin lymphoma

Diagn Interv Radiol 2014;20(2):185-192
DOI: 10.5152/dir.2013.13174
Özgür Ömür
Yusuf Baran
Aylin Oral
Yeşim Ceylan
1. From the Department of Nuclear Medicine Ege University School of Medicine, İzmir, Turkey
2. From the Department of Molecular Biology and Genetics İzmir Institute of Technology, İzmir, Turkey. Medicine
3. From the Department of Nuclear Medicine Ege University School of Medicine, İzmir, Turke
No information available.
No information available
Received Date: 28.04.2013
Accepted Date: 31.07.2013
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ABSTRACT

PURPOSE

We aimed to evaluate the role of fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) involving care-dose unenhanced CT to detect extranodal involvement in patients with non-Hodgkin and Hodgkin lymphoma.

MATERIALS AND METHODS

Lymphoma patients (35 Hodgkin lymphoma, 75 non-Hodgkin lymphoma) who were referred for 18F-FDG PET-CT imaging, following a diagnostic contrast-enhanced CT (CE-CT) performed within the last month, were included in our study. A total of 129 PET-CT images, and all radiologic, clinical, and pathological records of these patients were retrospectively reviewed.

RESULTS

In total, 137 hypermetabolic extranodal infiltration sites were detected by 18F-FDG PET-CT in 62 of 110 patients. There were no positive findings by CE-CT that reflected organ involvement in 40 of 137 18F-FDG-positive sites. The κ statistics revealed fair agreement between PET-CT and CE-CT for the detection of extranodal involvement (κ=0.60). The organs showing a disagreement between the two modalities were the spleen, bone marrow, bone, and thyroid and prostate glands. In all lesions that were negative at CE-CT, there was a diffuse 18F-FDG uptake pattern in the PET-CT images. The frequency of extranodal involvement was 51% and 58% in Hodgkin and non-Hodgkin lymphoma patients, respectively. There was a high positive correlation between the maximum standardized uptake values of the highest 18F-FDG-accumulating lymph nodes and extranodal sites (r=0.67) in patients with nodal and extranodal involvement.

CONCLUSION

18F-FDG PET-CT is a more effective technique than CE-CT for the evaluation of extranodal involvement in Hodgkin and non-Hodgkin lymphoma patients. PET-CT has a significant advantage for the diagnosis of diffusely infiltrating organs without mass lesions or contrast enhancement compared to CE-CT.