Metabolic test with fluorine-18-fluorodeoxyglucose in staging and detection of residual tumor or recurrence in Hodgkin lymphoma

Abstract

OBJECTIVE: The metabolic test using 18F-fluorodeoxyglucose is a useful tool for the management of patients with Hodgkin lymphoma, either for staging purposes or for the evaluation of suspicious masses that can frequently occur after treatment. The aim of the present study was to investigate the value of the 18F-fluorodeoxyglucose test performed with a dual-head coincident gamma camera (CGC-PET with fluorodeoxyglucose) for the staging and the detection of residual tumor of patients with Hodgkin lymphoma. METHODS: Thirty-eight consecutive patients were included in this retrospective study; the metabolic test comprising CGC-PET with FDG was done in 18 patients for staging work-up (Group 1), and the results were compared to conventional clinical staging procedures that included computed tomography scans and bone marrow biopsy. The remaining 20 patients were evaluated with CGC-PET with fluorodeoxyglucose due to the presence of residual masses or a new lesion (Group 2). RESULTS: The 18F-Fluorodeoxyglucose metabolic test, CGC-PET with fluorodeoxyglucose, upstaged 5 (27%) of the Group 1 patients and detected more lesions (45) than conventional methods of staging (33). Of the 20 patients in Group 2, 11 had positive18F-fluorodeoxyglucosetests, and a viable tumor was confirmed in 9 patients. Regarding the 9 patients with negative fluorodeoxyglucose metabolic tests, the 1-year probability of recurrence was 11.8%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the CGC-PET with fluorodeoxyglucose test were 90%, 80%, 82%, 89%, and 85% respectively. CONCLUSIONS: The metabolic test comprising CGC-PET with fluorodeoxyglucose had a higher diagnostic accuracy than conventional methods in the staging of Hodgkin lymphoma and thus is a valuable noninvasive tool for the diagnosis of suspicious lesions.