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Annals of Oncology 10:1181-1184, 1999
© 1999 European Society for Medical Oncology


research-article

The role of positron emission tomography (PET) in the management of lymphoma patients

P. L. Zinzani1,, M. Magagnoli1, F. Chierichetti2, M. Zompatori3, G. Garraffa2, M. Bendandi1, F. Gherlinzoni1, C. Cellini1, V. Stefoni1, G. Ferlin2 and S. Tura1

1Institute of Hematology and Medical Oncology ‘Seràgnoli’ University of Bologna Italy
2Department of Nuclear Medicine-PET Center, Caslelfranco Veneto Hospital Italy
3Institute of Diagnostic Radiology, University of Bologna Italy

Correspondence to: P. L. Zinzani, MD, Istituto di Ematologia e Oncologia Medica ‘Seràgnoli’, Policlinico S.Orsola, Via Massarenti 9, 40138 Bologna, Italy. E-mail: seragnol{at}kaiser.alma.unibo.it

Background: Treatment of both Hodgkin's disease (HD) and aggressive non-Hodgkin's lymphoma (NHL) with abdominal presentation at the time of diagnosis is often followed by detection of residual masses by computed tomography (CT). However, CT is usually unable to disciminate between residual tumor and fibrosis/necrosis. We investigated the ability of fluorine-18 fluorodeoxyglucose positron emission tomography (PET) to differentiate between residual active tumor tissue and fibrosis.

Patients and methods: Forty-four patients with HD or aggressive NHL presenting abdominal involvement (41% with bulky mass) were studied with CT and PET at the end of chemotherapy ± radiation therapy.

Results: After treatment, seven patients had negative PET and CT, and none of them relapsed. The remaining 37 patients all had positive CT (abnormalities ≤10%). All of the 13 who also had positive PET relapsed (100%). By contrast, there was only 1 (4%) relapse among the 24 patients who were positive at CT but negative at PET. The two-year actuarial relapse-free survival rate was 95% for those with negative PET compared with 0% for positive PET patients (P < 0.000000).

Conclusions: In lymphoma patients with abdominal masses who present CT positivity at restaging, PET should be considered the noninvasive imaging modality of choice for differentiating early recurrences or residual disease from fibrosis.

abdominal mass, aggressive NHL, CT scan, HD, PET


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