Is CT scan still necessary for staging in Hodgkin and non-Hodgkin lymphoma patients in the PET/CT era?

Ann Oncol. 2006 Jan;17(1):117-22. doi: 10.1093/annonc/mdj024. Epub 2005 Sep 28.

Abstract

Background: The clinical impact of fused PET/CT data on staging and patient management of Hodgkin disease (HD) and non-Hodgkin lymphoma (NHL) was assessed.

Patients and methods: A total of 103 consecutive patients with newly diagnosed NHL (n = 68) and HD (n = 35) were assessed retrospectively. Three comparisons were carried out in an attempt to assess the added value of each modality.

Results: For NHL patients, there were significant differences between staging by CT versus PET/CT (P = 0.0001). Disease was upstaged by PET/CT in 31% (mostly in stages I and II) and downstaged in only 1% of patients. In 25% of the patients, the treatment approach was changed according to CT versus PET/CT findings. For HD patients, disease was upstaged by PET/CT in 32% and downstaged by PET/CT in 15% (P = NS). As for NHL, upstaging by PET/CT versus CT was evident mostly for stages I and II. The treatment strategy was altered as determined by CT versus PET/CT in 45% of the patients.

Conclusions: The addition of PET/CT to CT changed the management decisions in approximately a quarter of NHL and a third of HD patients, mostly in early disease stages. Thus, PET/CT performed as the initial staging procedure may well obviate the need for additional diagnostic CT in the majority of patients.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Hodgkin Disease / diagnostic imaging
  • Hodgkin Disease / pathology*
  • Humans
  • Lymphoma, Non-Hodgkin / diagnostic imaging
  • Lymphoma, Non-Hodgkin / pathology*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron-Emission Tomography / methods*
  • Prognosis
  • Radiopharmaceuticals
  • Retrospective Studies
  • Tomography, X-Ray Computed

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18