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Nuklearmedizin 2005; 44(01): 1-7
DOI: 10.1055/s-0038-1623923
Original Article
Schattauer GmbH

Staging in childhood lymphoma

Differences between FDG-PET and CTStaging von kindlichen LymphomenVergleich von FDG-PET und CT
S. Hermann
1   Department of Nuclear Medicine (Director: Prof. Dr. Dr. O. Schober), University Hospital, Münster, Germany
,
D. Wormanns
2   Clinical Radiology (Director: Prof. Dr. W. Heindel), University Hospital, Münster, Germany
,
M. Pixberg
1   Department of Nuclear Medicine (Director: Prof. Dr. Dr. O. Schober), University Hospital, Münster, Germany
,
A. Hunold
3   Pediatric Hematology/Oncology (Director: Prof. Dr. H. Jürgens), University Hospital, Münster, Germany
,
W. Heindel
2   Clinical Radiology (Director: Prof. Dr. W. Heindel), University Hospital, Münster, Germany
,
H. Jürgens
3   Pediatric Hematology/Oncology (Director: Prof. Dr. H. Jürgens), University Hospital, Münster, Germany
,
O. Schober
1   Department of Nuclear Medicine (Director: Prof. Dr. Dr. O. Schober), University Hospital, Münster, Germany
,
C. Franzius
1   Department of Nuclear Medicine (Director: Prof. Dr. Dr. O. Schober), University Hospital, Münster, Germany
› Author Affiliations
Further Information

Publication History

Received: 18 June 2004

27 September 2004

Publication Date:
11 January 2018 (online)

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Summary

Aim: The clinical value of positron emission tomography using fluorine-18 fluoro-deoxy-glucose (FDG-PET) in the staging of adult lymphoma has been shown in many studies. However, there are only few data regarding childhood lymphoma. The purpose of this retrospective study was to compare the staging of childhood lymphoma using FDG-PET and the established computed tomography (CT). Method: Whole-body FDG-PET was performed in 25 children with histologically proven Hodgkin ´s disease (n = 18) and non-Hodgkin´s lymphoma (n = 7) using a dedicated PET. The findings were compared with the CT results. Both examinations, FDG-PET and CT, were assessed by two experienced physicians. In each patient, 30 regions were analysed (22 nodal, 8 extranodal). Each region was assessed using a fivevalue scale (definitely/probably positive, equivocal, probably/definitely negative). Results: 662 regions (470 nodal, 192 extranodal) were compared. 91 regions (81 nodal, 10 extranodal; 14%) were concordant positive and 517 regions (347 nodal, 170 extranodal; 78%) were concordant negative. In 47 regions, 48 discordant findings (7%) were described: 27 findings (22 nodal, 5 extranodal) were positive using FDG-PET and negative using CT whereas 21 findings (17 nodal, 4 extranodal) were positive using CT and negative using PET. A total of 7 regions (1%) were judged equivocal in one imaging modality (1 FDG-PET, 6 CT). Using FDG-PET as compared to CT, resulted in a higher staging in 4 of 25 patients and in a lower staging in 2 of 25 patients. Conclusion: Staging of childhood lymphoma using FDGPET shows differences compared with CT resulting in a different staging in 6 of 25 patients. Prospective studies are required to evaluate the impact of these discrepancies on the clinical management of pediatric patients.

Zusammenfassung

Der klinische Nutzen der FDG-PET hinsichtlich des Stagings und der Therapiekontrolle bei adulten Patienten mit Lymphomerkrankung konnte in einer Vielzahl von Studien gezeigt werden. Im Kindesalter gibt es hierzu nur wenige Daten. Ziel dieser retrospektiven Studie ist der Vergleich der Ganzkörper-FDG-PET und der CT beim Staging des M. Hodgkin (HD) und der Non-Hodgkin- Lymphome (NHL) im Kindesalter. Methode: Bei 25 pädiatrischen Patienten mit histologisch gesicherten Lymphomen (18 HD, 7 NHL) erfolgten FDG-PET-Untersuchungen in Ganzkörpertechnik. Die FDG-PET-Aufnahmen wurden im Vergleich zu denen mit CT von je zwei erfahrenen Untersuchern hinsichtlich der Erkennung von Lymphommanifestationen analysiert. Zum Vergleich wurde eine Einteilung in 30 Regionen pro Patient (22 nodal, 8 extranodal) vorgenommen. Die FDG-PET und die CT wurden in jeder Region jeweils mit einer 5-Wert-Skala (sicher/wahrscheinlich positiv, unbestimmt, wahrscheinlich/ sicher negativ) beurteilt. Ergebnisse: Insgesamt wurden 662 Regionen (470 nodal, 192 extranodal) analysiert. 91 Regionen (81 nodal, 10 extranodal; 14%) wurden konkordant positiv und 517 Regionen (347 nodal, 170 extranodal; 78%) konkordant negativ befundet. In 47 Regionen wurden 48 Läsionen diskordant bewertet (7%): 27 Läsionen (22 nodal, 5 extranodal) waren positiv in der FDG-PET und negativ in der CT, 21 Läsionen (17 nodal, 4 extranodal) hingegen negativ in der FDG-PET und positiv in der CT. 7 Regionen (1%) wurden mit einer der beiden bildgebenden Methoden als unbestimmt eingestuft (1 FDG-PET, 6 CT). Im Vergleich zur CT ergibt sich in der FDG-PET bei 4 von 25 Patienten ein höheres Staging und bei 2 von 25 Patienten ein niedrigeres Staging. Schlussfolgerung: Mit der FDG-PET ergeben sich im Vergleich zur CT bei Lymphomen im Kindesalter Unterschiede, die bei 6 von 25 Patienten zu einem anderen Staging führen. Prospektive Studien mit Validierung der diskrepanten Befunde werden benötigt.

Keywords

Paediatrics - lymphoma - Hodgkin - staging

Schlüsselwörter

Pädiatrie - Lymphom - Hodgkin - Staging
 

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