Is it wise to eliminate lymphography from the staging of Hodgkin's disease?

We believe that lymphography and CT are complementary rather than mutually exclusive techniques for the diagnosis and staging of HD. Unfortunately, it seems that many radiologists and clinicians disregard the ability of lymph ography to provide qualitative information on lymph node architecture, whic h is not available by CT. The use of lymphography is declining in several t eaching centers throughout the world. This makes it difficult for young rad iologists to acquire the skills needed to perform and interpret lymphograph ies successfully. In turn. radiologists who have little experience with lym phography are less likely to use the technique. Because most of the treatme nt-related morbidity in HD is dose-related, and because lymphography helps to avoid over- and undertreatment, we believe that high-quality lymphograph y continues to have a significant role in the staging of selected HD patien ts. Moreover, lymphography may reduce both the cost of management and the m orbidity rate in many HD patients. One solution would be to continue to use lymphography in a small number of institutions specialized in the manageme nt of HD.