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Positron emission tomography with 2-[18F]-Fluoro-2-Deoxy-D-Glucose for initial staging of hodgkin lymphoma: a single center experience in Brazil

Cerci, Juliano Julio; Pracchia, Luís Fernando; Soares Junior, José; Linardi, Camila da Cruz Gouveia; Meneghetti, José Claudio; Buccheri, Valeria.
Clinics ; 64(6): 491-498, June 2009. ilus, tab
Artigo em Inglês | LILACS | ID: lil-517918

BACKGROUND:

2-[18F]-Fluoro-2-Deoxy-D-Glucose (FDG-PET) is a well established functional imaging modality for the initial staging of Hodgkin lymphoma (HL) in patients from Western Europe and North America. The reliability of FDG-PET in populationsof different ethnic groups is unclear, as all investigations published to date have come from developed countries.

PURPOSE:

The aim of the present study was to investigate the effectiveness of FDG-PET in the initial staging of HL patients in a Brazilian population.

METHODS:

Eighty-two patients with newly diagnosed HL were prospectively included in the study. All patients were staged with both conventional clinical staging (CCS) methods, including computed tomography (CT) and whole-body FDG-PET methods. A standard of reference for the nodal regions and the extranodal organs was determined using all available information, including the CCS methods, FDG-PET, the diagnostic histology and the follow-up examinations. The results of the CCS were then compared to the FDG-PET results.

RESULTS:

The sensitivity of FDG-PET was higher for nodal staging than that of CT (87.8% vs. 61.6%, respectively). FDG-PET was also more sensitive than CT in regard to evaluating the extranodal organs for lymphomatous involvement (96.2% vs. 40.0%, respectively). FDG-PET detected all 16 patients who were characterized by a positive bone marrow biopsy and identified an additional 4 patients with bone marrow disease. The incorporation of FDG-PET coupled with CCS in the staging procedure upstaged 20% (17/82) of the patients and downstaged 11% (9/82) of the patients. As a result of these changes in staging, 15% (13/82) of the patients would have received a different therapeutic regimen.

CONCLUSIONS:

The FDG-PET method is superior to CT for the detection of nodal and extra-nodal HL. The observation that the FDG-PET method upstaged the...
Biblioteca responsável: BR1.1