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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The PET-FDG is a useful method to assess the post-radiotherapy residual masses in supradiaphragmatic lymphoma patients. We present the case of a patient with residual mediastinic mass revealed by CT after the patient had completed treatment for Hodgkin's disease and in whom the PET study demonstrated a typical pattern of post-radiation pneumonitis. When these patients are re-assessed early after radiotherapy, the different tracer uptake patterns should be taken into account in order to identify the existence of radiotherapy sequela and avoid false positive results.
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PMID:[Post-radiation pneumonitis in a case of Hodgkin's lymphoma assessed with PET-FDG by residual mediastinal mass]. 1106

Purpose: To compare the sensitivity of F18 - FDG Positron Emission Tomography (PET), Computed Tomography (CT) and Planar Gallium 67-Citrate (GS) in the diagnosis of Hodgkin's Disease.Materials and Methods: Thirty (30) adult patients with histopathologically confirmed diagnosis of Hodgkin's Disease between Oct 97 and June 98 at KFSH & RC had the three diagnostic imaging modalities for the initial work up; in twenty eight patients for newly diagnosed and in two patients for recurrent disease. Nodular sclerosis was the histological subtype in 25 patients, mixed cellularity in 3 and lymphocytic predominance in 2.Results: For the initial evaluation of the results, a positive site by any of the three diagnostic imaging modalities was considered actual location of the disease. The patient-site sensitivity of PET, CT and for GS were 93.33%, 80% and 53.3% respectively. False negative results were observed in 2 patients with PET, 7 with CT and 14 with GS. The Spleen was the commonest site for false negative result in GS (4 patients) axilla and bones in CT (2 patients each), the 2 patients with false negative results with PET were in the lung. The difference in sensitivity between PET and GS was statistically significant (P = 0.002), but was not significant between PET and CT (P = 0.18). Although CT showed better sensitivity and accuracy when compared with GS, that didn't reach statistical significance (P = 0.09).Conclusion: PET Scan has the highest sensitivity in the initial evaluation in this small group of patients with Hodgkin Disease, especially when compared with GS. Evaluations of the final sensitivity, specificity and accuracy of these imaging modalities will be presented.
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PMID:25. Positron Emission Tomography in Hodgkin's Disease. Correlation with Computed Tomography and Gallium 67 Citrate Imaging. 1115 Jul 82

We report on a patient with Hodgkin's disease who presented with hypodense splenic lesions and corresponding increased glucose metabolism in FDG-PET imaging, four months after completion of initial treatment, suggestive of early relapse. Serological testing for toxoplasma gondii, however, showed evidence of a recently reactivated or newly acquired infection. Three weeks after immediate antibiotic treatment with Daraprime and Sulfadiazin, the splenic lesions had completely resolved. Additionally, serological titers for toxoplasma gondii were normalized and whole body FDG-PET imaging showed no metabolic activity. Although the positive predictive value of PET imaging to indicate lymphoma is reported to be higher than CT, hypermetabolic lesions are not specific for malignant tissue. Whereas benign tumors typically show low glucose metabolism, activated granulocytes and macrophages may display significantly increased glucose consumption. In conclusion, our case report shows that although therapeutic decisions are often based on the results of imaging modalities, the taking of a detailed history and the acquisition of histological confirmation of the suspected lymphoma relapse are also advisable where possible. Cellular immunodeficiency can result in severe infections even in patients with intermediate stage Hodgkin's lymphoma in remission after combined modality treatment. Therefore, despite the high sensitivity of FDG-PET imaging for the detection of recurrent lymphoma, the differential diagnosis of infectious lesions should be kept in mind, in particular in immunocompromised patients.
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PMID:Pitfalls in imaging Hodgkin's disease with computed tomography and positron emission tomography using fluorine-18-fluorodeoxyglucose. 1143 34

The reliable assessment of residual masses after treatment as well as of new lesions suspected for relapse remains a diagnostic problem in patients with Hodgkin's disease (HD). The current study compares the results obtained by CT scan to FDG-PET imaging in a blind analysis with respect to the viability of residual masses and in case of suspected relapse. Between 1/94 and 10/99, 47 comparisons of PET and corresponding CT scans - 26 comparisons in 24 patients with residual tumors and 21 comparisons in 20 patients with suspected relapse of HD - were evaluated by independent reviewers blinded to he results of each other. Patients with primary diagnosis had been treated within trials of the German HD Trial study group. Relapsed patients received intensified salvage chemotherapy regimens. PET was assessed visually and by quantifying glucose uptake (SUV). Changes in size of tumor lesions as well as contrast medium enhancement served as criteria for assessment by CT scans. Results were validated either by histologic examination of a resected mass or biopsy (n=17) or by a clinical follow-up over 6 months following treatment (n=30). In 26 cases with residual lesions FDG-PET showed an increased tracer uptake in 8, 7 of which were true positive (TP) and 1 false positive (FP). Eighteen cases were classified as being negative (no viable HD), 17 true negative (TN) and 1 FN. In the blinded reading of the corresponding CT scans, 10 cases with residual lesions were considered to contain vital lymphoma (2 TP, 8 FP). Sixteen CT scans were classified as negative (10 TP, 6 FN). The resulting sensitivity and specificity of PET were 87.5% and 94.4% in contrast to only 25% and 56% for CT scans. The positive and negative predictive values of PET and CT scans were 87.5% and 94.4% and 20% and 62.5%, respectively. In patients with suspected relapse, sensitivity and positive predictive value for the diagnosis of the relapse were 100% and 86%, respectively, yielding the same results for both methods. FDG-PET performed in HD patients with residual masses appears to offer important additional information regarding the presence of viable HD in these residual lesions. In patients with suspected relapse of HD, FDG-PET seems not to offer any information over CT scans. Using SUVs is not superior to visual assessment of PET alone.
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PMID:Comparison of 18FDG-PET with CT scans in the evaluation of patients with residual and recurrent Hodgkin's lymphoma. 1160 73

FDG-PET is both able to provide information of lymphomatous organ involvement not available by conventional imaging techniques (US, CT, MRI) and to give reliable data otherwise obtainable only by using invasive procedures. As a whole body-screening technique, PET reduces diagnostic requirements and potential complications. Nevertheless the conventional imaging techniques are essential for the exact localisation and correct interpretation of PET findings. A number of factors that may produce false-positive results have to be taken into consideration, including post-treatment inflammatory changes and the sensitivity of the method in the setting of minimal residual disease. Despite its potential of a screening method being performed prior to other imaging procedures, PET is not yet established as a routine element for the primary staging of Hodgkin's disease and non-Hodgkin's lymphoma. Its value for re-staging is less doubtful due to the frequency of stage migration and possible changes in therapy related to the use of PET. Detailed cost-effectiveness studies are needed to assess the economic implications of an expanded use of PET in lymphoma therapy.
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PMID:Positron emission tomography and lymphoma therapy. 1169 79

To assess the ability of restaging positron emission tomography (PET) scanning to predict clinical outcome after first-line treatment in patients with Hodgkin's disease, we included 60 patients with histologically proven HD, who underwent whole-body [(18)F]-fluorodeoxygenase ([(18)F]-FDG)-PET studies after first-line treatment and with a follow-up of at least 1 year. Persistence or absence of residual disease on PET was related to progression-free survival (PFS) using Kaplan-Meier survival analysis. After treatment, 55 patients showed a normal [(18)F]-FDG-PET scan; 50 of 55 remained in complete remission (CR), with a median follow-up of 955 d. Only five patients relapsed (median PFS, 296 d). During follow-up in all five patients, [(18)F]-FDG-PET was the first tool that became positive for relapse. Persistent abnormal [(18)F]-FDG uptake was seen in only five patients; all of them relapsed (median PFS, 296 d). In four of five patients, only PET predicted persistent disease. All relapses were proven histologically. Two-year actuarial PFS rate for negative patients was 91% compared with 0% for positive patients. We concluded that [(18)F]-FDG-PET has an important prognostic role in the post-treatment evaluation of HD patients.
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PMID:Can positron emission tomography with [(18)F]-fluorodeoxyglucose after first-line treatment distinguish Hodgkin's disease patients who need additional therapy from others in whom additional therapy would mean avoidable toxicity? 1170 21

Fluorine-18fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) has become a very useful technique for the therapy monitoring of patients with lymphoma. It provides unique information about the metabolic behavior of the disease independent of morphological criteria. In recent years, [18F]FDG-PET has proven to be a technique with high sensitivity for the detection of residual tumor. Therefore, [18F]FDG-PET seems to be the ideal tool for the evaluation of treatment response. However, most recent published studies included both HD and NHL, although [18F]FDG-PET scan results in Hodgkin's disease (HD) has a different impact than in Non Hodgkin's Lymphoma (NHL). In this paper, we summarize our findings on the role of [18F]FDG-PET in the therapy evaluation of lymphoma patients in a large group of patients and highlight the differences between the interpretations of the results of HD and NHL patients. Finally, a strategy for the implementation of [18F]FDG-PET in the management of lymphoma patients is proposed.
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PMID:Evaluation of treatment response in patients with lymphoma using [18F]FDG-PET: differences between non-Hodgkin's lymphoma and Hodgkin's disease. 1178 19

This study evaluates and compares the accuracy of positron emission tomography with 18F-fluoro-2-deoxyglucose (FDG-PET) and gallium-67 citrate (Ga-67) scintigraphy in identifying disease sites in patients with malignant lymphoma at initial diagnosis or relapse. Histology subgroups included low (n=5), intermediate (n=6), high-grade (n=5) non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) (n=14). Ann-Arbor staging included 7 patients in stage I, 8 in stage II, 9 in stage II, 6 in stage IV and 11 extra-nodal. In this study, before any therapy, 25 contemporaneous FDG-PET and Ga-67 scintigraphies were performed on patients with either NHL (16) or HD (14). One hundred and eleven sites of disease were correlated on a site-by-site basis in corresponding areas of FDG-PET and Ga-67 scintigraphy. Discordant FDG-PET and Ga-67 scintigraphic findings were correlated with CT/MRI and clinical evaluation. FDG-PET detected malignant lymphoma in 24/25 patients (sensitivity: 96.0%). There was a false-negative FDG-PET result in only 1 patient with low-grade gastric malignant lymphoma. Ga-67 scintigraphy detected malignant lymphoma in 18/25 patients (sensitivity: 72.0%). There were false-negative Ga-67 scintigraphic results in 4 cases with low-grade non-Hodgkin's lymphoma, 2 cases with bone or bone marrow involvement, and 3 smaller disease sites. FDG-PET upstaged 6 patients in whom Ga-67 scintigraphy detected disease sites partially. In imaging lymphoma prior to therapy, FDG-PET had a higher sensitivity and detected significantly more disease sites when compared with Ga-67 scintigraphy in the initial evaluation of this group of patients. Upstaging of patients with FDG-PET may result in a change in treatment strategy. However, evaluation of the final sensitivity, specificity and accuracy of these imaging modalities will need a further study with a larger patient number.
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PMID:Comparison of 18F-fluoro-2-deoxyglucose positron emission tomography and gallium-67 citrate scintigraphy for detecting malignant lymphoma. 1183

We have determined the predictive value of [18F]2-fluoro-2-deoxy-glucose (FDG-PET) in patients with Hodgkin's disease (HD) and aggressive non-Hodgkin's lymphoma (NHL) scheduled for high-dose therapy with stem cell transplantation (HDT/SCT). Inclusion criteria were the presence of an FDG-PET scan after chemotherapy (ChT) within 8 weeks prior to HDT/SCT and available follow-up data. Sixteen patients (10 NHL and six HD) were observed during a follow-up period of 4 to 28 months (median 13 months). Before SCT, five patients had a negative PET, three were weakly positive, two moderately positive, and six strongly positive. None of the five patients with a negative PET before HDT/SCT relapsed and two of three patients with a weakly positive scan are still in remission after HDT/SCT. Of eight patients with a moderate or high positive PET before HDT/SCT, seven relapsed and one died of early HDT/SCT related complications (P< 0.01). Three of eight relapsing patients died of lymphoma 5 to 10 months after SCT and in one additional patient not responding to HDT/SCT, the main cause of death was chronic toxicity 4 months after transplantation. After 12 months, in PET-negative patients the overall and relapse-free survival was 100%, in PET-positive patients 55% and 18%, respectively. In NHL, two patients with negative PET, but with an age-adjusted international prognostic index (AaIPI) of 2 and one with AaIPI = 1 are still in remission. In the seven PET-positive subjects, one patient with AaIPI = 0, three with AaIPI = 1, and two with AaIPI = 2 relapsed. We conclude that FDG-PET is accurate in the prediction of relapse prior to HDT/SCT in patients with lymphoma. It provides additional information when compared with the AaIPI.
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PMID:Positron emission tomography with [18F]2-fluoro-D-2-deoxyglucose (FDG-PET) predicts relapse of malignant lymphoma after high-dose therapy with stem cell transplantation. 1184 Feb 93

Malignant lymphoma is one of the tumors that show high FDG uptake, enabling the accurate detection of small involved lesions by FDG-PET. It is useful in both initial staging and follow-up study. In initial staging, FDG-PET is superior to CT from the aspects of sensitivity and specificity, and it is reported that the therapeutic protocol has been changed in 21% of patients. In the follow-up of therapy and detection of recurrence, the accuracy of residual disease is reported to be more than 90%. Among the different pathological types of lymphoma, Hodgkin's disease and intermediate-grade NHL are typical indications because of the requirement of accurate staging in determining the therapeutic protocol. One of the shortcomings of FDG-PET is its low specificity. Combination study with PET tracers with higher specificity in tumor diagnosis such as C-11 methionine or F-18 methyltyrosine could be a way to solve this problem.
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PMID:[Current status of nuclear medicine. Clinical application of FDG-PET for cancer diagnosis. Malignant lymphoma]. 1207 34


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