Radiology 1997 Jun;203(3):795-800
Lymphoma: role of whole-body 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) PET in
nodal staging.
Moog F, Bangerter M, Diederichs CG, Guhlmann A, Kotzerke J, Merkle E, Kolokythas
O, Herrmann F, Reske SN.
PURPOSE: To compare 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) positron
emission tomography (PET) with computed tomography (CT) in primary nodal staging
of malignant lymphoma. MATERIALS AND METHODS: Sixty consecutive patients with
untreated, histopathologically proved malignant lymphoma (aged 7-72 years; 33
with non-Hodgkin lymphoma, 27 with Hodgkin disease) underwent FDG PET and
contrast material-enhanced CT for nodal staging. Lymph node regions identified
at both CT and PET were regarded as actual locations of disease. Discordant
results were verified with biopsy or clinical follow-up whenever possible.
RESULTS: One hundred sixty of 740 evaluated lymph node regions were identified
as diseased at both CT and PET. Of the 25 additional regions seen with PET,
seven were true-positive; two, false-positive; and 16, unresolved. CT showed six
additional disease manifestations; three were false-positive, and three were
unresolved. Staging was changed in the four patients with the seven confirmed
additional PET findings: from stage I to II in one patient and from stage II to
III in three patients. Staging was changed from stage II to I in one of the
three patients with false-positive CT findings. CONCLUSION: FDG PET may be more
accurate for detecting nodal lymphoma than incremental CT.