WHOLE-BODY 2-[F-18]-FLUORO-2-DEOXY-D-GLUCOSE POSITRON-EMISSION-TOMOGRAPHY (FDC-PET) FOR ACCURATE STAGING OF HODGKINS-DISEASE

Background: Staging of Hodgkin's disease (HD) is accomplished by a var iety of invasive and non-invasive modalities. This prospective study w as undertaken to investigate the value of whole-body positron emission tomography (PET) with 2-[F-18]-fluoro-2-deoxy-D-glucose (FDG) in defi ning regions involved by lymphoma compared with conventional staging m ethods in patients with HD. Patients and methods: Fourty-four newly di agnosed patients with HD underwent FDG-PET as part of their initial st aging work-up. PET findings were correlated with findings of conventio nal staging including computed tomography, ultrasound, bone scanning, bone marrow biopsy, liver biopsy and laparotomy. When results of FDG-P ET differed to those obtained by conventional methods reevaluation was performed by biopsy, if possible, or magnetic resonance imaging. Resu lts: The results of FD G-PET were compared with three hundred twenty-o ne conventional staging procedures performed in 44 patients. FDG-PET w as positive in 35 of 44 (86%) patients at sites of documented disease. PET detected additional lesions in five cases previously not identifi ed by conventional staging methods. In another case a nodal lesion sus pect on CT was negative at FDG-PET and was settled as true negative by biopsy. As a consequence of PET findings five patients had to be upst aged and one patient had to be down-staged, resulting in changes in tr eatment strategy in all six cases (14%). FDG-PET failed to visualize s ites of HD in four patients. In two of our patients a false positive P ET result was obtained. Conclusions: Our data indicate that FDG-PET pr ovides an imaging technique that appears to visualize involved lesions in most patients with HD and is useful in the managment of these pati ents.