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Annals of Oncology Advance Access originally published online on September 28, 2005
Annals of Oncology 2006 17(1):117-122; doi:10.1093/annonc/mdj024
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© 2005 European Society for Medical Oncology

Is CT scan still necessary for staging in Hodgkin and non-Hodgkin lymphoma patients in the PET/CT era?

P. Raanani1,4,*, Y. Shasha2,4, C. Perry3,4, U. Metser2,4, E. Naparstek3,4, S. Apter4,6, A. Nagler4,5, A. Polliack3, I. Ben-Bassat4,5 and E. Even-Sapir2,4

1 Rabin Medical Center, Department of Hematology; 2 Tel-Aviv Sourasky Medical Center, Department of Nuclear Medicine; 3 Department of Hematology; 4 Tel-Aviv University, Sackler School of Medicine, Tel-Aviv; 5 The Chaim Sheba Medical Center, Department of Hematology; 6 Department of Radiology, Ramat-Gan, Israel

* Correspondence to: Dr P. Raanani, Rabin Medical Center, Institute of Hematology, Campus Beilinson, Sackler School of Medicine, Tel-Aviv University, Petah-Tikva, 49100 Israel. Tel: +972-3-9378207; Fax: +972-3-6992463; E-mail: praanani{at}012.net.il

Background: The clinical impact of fused PET/CT data on staging and patient management of Hodgkin disease (HD) and non-Hodgkin lymphoma (NHL) was assessed.

Patients and methods: A total of 103 consecutive patients with newly diagnosed NHL (n = 68) and HD (n = 35) were assessed retrospectively. Three comparisons were carried out in an attempt to assess the added value of each modality.

Results: For NHL patients, there were significant differences between staging by CT versus PET/CT (P = 0.0001). Disease was upstaged by PET/CT in 31% (mostly in stages I and II) and downstaged in only 1% of patients. In 25% of the patients, the treatment approach was changed according to CT versus PET/CT findings. For HD patients, disease was upstaged by PET/CT in 32% and downstaged by PET/CT in 15% (P = NS). As for NHL, upstaging by PET/CT versus CT was evident mostly for stages I and II. The treatment strategy was altered as determined by CT versus PET/CT in 45% of the patients.

Conclusions: The addition of PET/CT to CT changed the management decisions in approximately a quarter of NHL and a third of HD patients, mostly in early disease stages. Thus, PET/CT performed as the initial staging procedure may well obviate the need for additional diagnostic CT in the majority of patients.

Key words: PET/CT, Hodgkin disease, non-Hodgkin lymphoma, staging


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