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Keywords:

  • 18F-fluorodeoxyglucose;
  • positron emission tomography;
  • gallium scintigraphy;
  • lymphoma;
  • World Health Organization classification

Abstract

BACKGROUND.

Although studies comparing conventional imaging modalities with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) for the detection of lymphoma and although the relations between 18F-FDG-PET and histologic types were reported previously, most studies were not systematic and involved relatively small numbers of patients.

METHODS.

Two hundred fifty-five patients with lymphoma had their disease staged using 18F-FDG-PET, and 191 of those patients also were assessed using gallium-67 scintigraphy (67Ga). Disease sites were identified on a site-by-site basis using computed tomography scans and/or magnetic resonance imaging. The results of these conventional imaging modalities were compared with the results from 8F-FDG-PET and 67Ga, and correlations between the imaging results and pathologic diagnoses were evaluated by using the World Health Organization classification system.

RESULTS.

Of 913 disease sites in 255 patients, 18F-FDG-PET identified >97% of disease sites of Hodgkin lymphoma (HL) and aggressive and highly aggressive non-Hodgkin lymphoma. For indolent lymphoma, the detection rate of 18F-FDG-PET was 91% for follicular lymphoma (FL); 82% for extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, irrespective of plasmacytic differentiation; and approximately 50% for small lymphocytic lymphoma (SLL) and splenic marginal zone lymphoma (SMZL). The results from 67Ga were similar to those from 18F-FDG-PET for most histologic subtypes. However, the sensitivity of 67Ga was unexpectedly poor for FL, for mantle cell lymphoma (MCL), and for the nasal type of natural killer/T-cell lymphoma (NK/T-nasal), ranging from 30% to 38%.

CONCLUSIONS.

18F-FDG-PET was useful for all histologic subtypes of lymphoma other than SLL and SMZL. Compared with 67Ga, the authors strongly recommend the use of 18F-FDG-PET in patients with FL, MCL, and NK-nasal. Cancer 2007. © 2007 American Cancer Society.