Hounsfield units from unenhanced 18F-FDG-PET/CT are useful in evaluating supradiaphragmatic lymph nodes in children and adolescents with classical Hodgkin’s lymphoma

Abstract

Background. The precise identification of the primarily-affected nodal regions in Hodgkin's lymphoma (HL) is essential in determining the stage of the disease and the intensity of chemotherapy and radiotherapy.

Hounsfield units and fractal dimension (test HUFRA) for determining PET positive/negative lymph nodes in pediatric Hodgkin’s lymphoma patients

“…Additionally, this assessment can be carried out retrospectively. High concordance between PET and CT data for nodal regions has been determined in pediatric HL and highlighted in previous studies [11]. The method presented in our research cannot be used in the case of lymph nodes with a high value of only 1 of the 2 parameters-XRA max LN/M or FD max .…”

“…However, a detailed analysis of CT images allows for the determination of additional tissue parameters, such as homogeneity/heterogeneity, which can also serve as a source of useful information [10]. In one of our previous studies, we demonstrated the practical usefulness of HU values in HL cases in the pediatric population [11]. We had shown that density values (measured in Hounsfield units) are much higher in malignant lymph nodes compared to "benign" ones when the standard metabolic criteria (Deauville scale) are considered as the reference point.…”

“…The measurements of the right erector spinae muscle were performed in axial sections of the CT at the arising area of celiac and superior mesenteric arteries. The detailed description of a ROI selection and determination of XRA max of the right erector spinae muscle was provided in our previous publication [11].…”

“…The role and significance of FD in the radiological diagnosis of lymphomas, particularly in CT examinations, remains unclear. In our previous research [11,17], we presented data showing a potential benefit of determination of FD and HU in the native CT study in Hodgkin's lymphoma in children. The results obtained in the present study, using simple measurement during initial CT examination, allow the accuracy of about 75-80% for qualifying lymph nodes as PET(+) or PET(-).…”

Linksseitiger Chylothorax und Tumor des rechten vorderen Mediastinums

“…Die Dichte war ähnlich der Dichte der vermeintlichen vergrößerten Lymphknoten im linken Hemithorax. Die Dichte von Lymphknoten wird mit 10 -80 HE angegeben, Lymphome liegen ebenfalls in diesem Bereich [6].…”