COMPARISON OF BONE AND GA-67 SCINTIGRAPHY IN THE INITIAL DIAGNOSIS OFBONE INVOLVEMENT IN CHILDREN WITH MALIGNANT-LYMPHOMA

The accurate staging of Hodgkin's disease (HD) and non-Hodgkin's lymph oma (NHL) in children has important therapeutic and prognostic implica tions. The presence of secondary bone involvement or primary malignant lymphoma of bone can be determined by both radiographic and radionucl ide methods. We wished to compare the relative efficacy of bone and Ga -67 scintigraphy for detecting the presence of bone involvement by mal ignant lymphoma. We evaluated 83 children (mean age 12 years) with his tologically proven HD and NHL utilizing bone and Ga-67 scintigraphy wh ich were performed prior to treatment. Three of these patients had bio psy proven primary malignant lymphoma of bone. Bone scintigraphy detec ted 18 bone lesions in 13 patients and Ga-67 scintigraphy detected the same 18 bone lesions and in addition 101 extraosseous lesions. Radiog raphy confirmed the presence of focal bone lesions. Both osteolytic an d osteoblastic lesions were identified. We conclude that bone scintigr aphy is not necessary in the initial staging of children with malignan t lymphoma unless there are specific osseous symptoms. Ga-67 scintigra phy is the radionuclide method of choice in the initial staging of chi ldren with malignant lymphoma.