Acta Oncol 1999;38(6):799-804
Positron emission tomography with 18-fluorodeoxyglucose in the staging and
follow-up of lymphoma in the chest.
Bangerter M, Kotzerke J, Griesshammer M, Elsner K, Reske SN, Bergmann L.
The purpose of this retrospective study was to evaluate the accuracy of positron
emission tomography (PET) using 18-F-fluorodeoxyglucose (FDG) in predicting
lymphomatous involvement in the hilar and mediastinal regions in the staging and
follow-up of patients with malignant lymphoma. One hundred forty-seven thoracic
PET studies in 89 consecutive lymphoma patients were reviewed. Static FDG-PET
imaging was performed following application of 270 MBq FDG (mean). Results of
FDG-PET were compared with the findings of computed tomography (CT) in all
patients and clinical follow-up examination. Eighty-nine of 147 (60%) PET
studies showed no FDG uptake in the hilar or mediastinal regions, while 58 (40%)
studies did detect FDG uptake in these regions. In 52 of 58 abnormal studies
(90%), lymphomatous involvement of the hilar and/or mediastinal regions seen by
CT was present. In the remaining six abnormal PET studies (10%), FDG uptake was
considered as false-positive because of missing lesions on corresponding CT
scans. In four patients false-positive FDG uptake was observed before treatment,
in two patients after completion of therapy. In these two patients FDG uptake
after therapy was caused by thymus hyperplasia. The remaining four cases before
treatment remained unresolved. Sensitivity of FDG-PET was 96%, specificity 94%,
positive predictive value 90%, and negative predictive value 98%, respectively.
The present study suggests that FDG-PET has potential value in predicting
lymphomatous involvement in the hilar and mediastinal regions. FDG-PET may
obviate invasive diagnostic procedures in patients with lymphoma.
