Aims and objectives
The accuracy of initial staging is critically important because of the further differences in the intensity,
duration of the therapy and the prognosis of the disease.
Initial stage of paediatric HL depends on the spread of the lymphomatous process and determined by diffrent imaging modalities (conventional contrast-enhanced (CE) computed tomography (CT),
18F-Fluorodeoxyglucose (18F-FDG) PET/CT).
At a present time,
there is no commonly accepted diagnostic algorithm for staging pediatric HL.
Children with HL sequentially undergo a lot of unnecessary scanning (for example,
enhanced CT followed with...
Methods and materials
Patient population: 77 pediatric patients (mean age 13.8+-4.2 years) with histologically proven HL underwent pretreatment full body CE CT followed with 18F-FDG-PET/CT (not later than two weeks after CT) as a part for the initial staging of the disease.
Exclusion criteria: patients with pathological lymphadenopathy caused not by the lymphomatous process:
primary immunodeficiency(PID),
sarcoidosis
tuberculosis
Lymphomatous involvment:
On CT
1. Lymph nodes with short axis greater then 10mm,
or long axis greater then 15mm
2. Pathological contrast enhancement of parenchymal organs
3. Consolidation origins and...
Results
96
PET/CT results were compared with CE CT.
Of the 264 that were considered fo the analysis PET/CT and CT were judged as concordantly positive in 234 regions (86%).
F-18 FDG-PET and CT were discordant in 42 regions(16%),
with a positive result on F-18 FDG-PET and negative findings on CT in 37 regions (14%).
In the remaining 5 regions (1,8 %),
F-18 FDG-PET was reported as negative and CT as positive.
After CT staging,
PET/CT findings resulted in a change of the disease staging in...
Conclusion
96
This main goal of this study was to test the value of F-18 FDG-PET/CT imaging for the initial staging and to compare it with CT.
According to the results of the current study,
PET/CT correctly resulted in a change of disease staging (and therefore a change in treatment regimen) in every third child with HL.
We suggest that FDG-PET/CT is a reliable diagnostic tool for pretreatment staging HL in children and we recommend it to be the first modality for the purpose of the...
References
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