J Nucl Med 1999 Sep;40(9):1407-13
FDG PET can replace bone scintigraphy in primary staging of malignant
lymphoma.
Moog F, Kotzerke J, Reske SN.
Recent studies indicated that 18F-fluorodeoxyglucose (FDG) PET may be more
accurate than CT in staging nodal and extranodal malignant lymphoma. The
objective of this study was to compare conventional bone scintigraphy as an
established skeletal staging procedure with PET using FDG in the detection of
osseous involvement in malignant lymphoma. METHODS: Whole-body PET-based staging
studies of 56 consecutive patients with proven Hodgkin's disease (n = 34) or
non-Hodgkin's lymphoma (n = 22) were compared with the results of bone
scintigraphy. Positive PET or bone scintigraphic findings were confirmed, if
possible, by biopsy, MRI, CT or radiographic investigations. RESULTS: Of the 56
patients studied, 12 were found to have skeletal involvement on both studies
(PET, 30 regions; bone scintigraphy, 20 regions). Findings were confirmed in all
12 patients. FDG PET detected an additional 12 involved regions in 5 patients.
This was subsequently verified in 3 patients, although the other 2 cases
remained unresolved. Conversely, bone scintigraphy revealed five abnormalities
compatible with lymphoma in 5 patients. Three of these lesions were found to be
erroneous; final evaluation of the remaining two findings was not possible.
CONCLUSION: FDG PET is suitable for identifying osseous involvement in malignant
lymphoma with a high positive predictive value and is thereby more sensitive and
specific than bone scintigraphy.
