SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY GALLIUM IMAGING VERSUS COMPUTED-TOMOGRAPHY - PREDICTIVE VALUE IN PATIENTS UNDERGOING HIGH-DOSE CHEMOTHERAPY AND AUTOLOGOUS STEM-CELL TRANSPLANTATION FOR NON-HODGKINS-LYMPHOMA

Purpose: To evaluate the predictive value of computed tomography (CT) scanning and single-photon emission computed tomography (SPECT) galliu m (Ga) scanning in the disease-free survival of patients receiving hig h-dose chemotherapy and autologous stem-cell transplantation for non-H odgkin's lymphoma (NHL). Patients and Methods: One hundred forty-three patients undergoing transplant for NHL underwent CT scanning of chest , abdomen, and pelvis, and a SPECT Ga scan before transplantation and at day + 100 after transplant. The failure-free survival (FFS) by scan result was analyzed. Results: In the diffuse aggressive lymphoma pati ents, the 1-year FFS for patients having a positive SPECT Ga scan at d ay + 100 was 15% compared with a 3-year FFS of 47% for those with a ne gative scan (P < .001). patients with a positive CT scan at day + 100 had a 36% 3-year FFS, and those with a negative CT scan had a 39% 3-ye ar FFS (P = not significant [NS]). An analysis of the combination of C T scan and SPECT Ga scan results at day + 100 posttransplant demonstra ted a 3-year FFS of 14% if they were both abnormal; if the CT was posi tive and Ga was negative, the 3-year FFS was 68%; positive Ga with a n egative CT was 25%; and both negative was 34% (P = .0015). For the pat ients with follicular NHL, those with a positive SPECT Ga at day + 100 had a 14% 1-year FFS compared with those with a negative scan, who ha d a 45% 3-year FFS (P < .001). In the follicular NHL patients, the 3-y ear FFS of those with a positive CT was 17% compared with a 64% 3-year FFS for patients with a negative CT scan (P < .001). Conclusion: The use of SPECT Ga scan at day + 100 posttransplant for evaluation of dis ease activity in patients with diffuse aggressive NHL was highly predi ctive of eventual outcome and was more predictive than the CT scan res ults. However, for patients with follicular NHL, the addition of SPECT Ga scanning to CT scanning did not odd substantially to the evaluatio n of transplant outcome. (C) 1996 by American Society of Clinical Onco logy.