Limited Positron Emission Tomography-Computed Tomography for Restaging of Lymphoma: A Strategy for Reducing Radiation Exposure among Patients with Early-Stage Curable Lymphoma

Abstract

Repeated imaging with positron emission tomography-computed tomography (PET-CT)is associated with cumulative exposure to substantial doses of radiation. Furthermore, PET-CT is an expensive and limited resource in many institutions. We conducted a retrospective analysis to evaluate whether limited PET-CT focused on the initially involved field of view (FOV) at diagnosis, corresponding to an above- or below-the-diaphragm scan, is sufficient for follow-up of patients with Hodgkin (HL) and aggressive non-Hodgkin lymphoma (NHL).One hundred thirty-one examinations of 44patients with early-stage (I-II) HL (n = 27) and aggressive NHL (n = 17) who had PET-CT performed as part of their initial staging and at follow-up were analyzed. Regardless of the extent of response to treatment, there was no single case in which the disease progressed outside of the initially involved FOV (0/44, 95% CI 0-0.08). This was true even in cases of disease progression, including in the setting of relapse. Our findings suggest that limited PET-CT analysis of the initially involved FOV in patients with early-stage curable lymphoma may be satisfactory for response assessment.

Diagnostic accuracy of pelvic magnetic resonance imaging for the assessment of bone marrow involvement in diffuse large B-cell lymphoma

“…If PET/CT is positive, BMinv can be diagnosed without BMB. However, PET/CT is quite expensive, which limits its application in the field of medicine [ 28 ]. Moreover, PET/CT exposes patients to high doses of radiation, especially as it may be used repeatedly, such as for staging and post-treatment evaluation.…”

Onkológiai betegek szoros képalkotó követése – előny vagy hátrány?

“…NHL követésében a teljestest-CT helyett régiókra célzott CT-vizsgálatok bevezetése ajánlott [41]. Lymphomakezelésre adott vá-lasz értékelésekor a kiindulási PET/CT-vel a látómezőre (field of view) összpontosított vizsgálatok csökkentik a sugárterhelést [46]. Mivel a malignus gócokban a szö-veti határok fellazulásával a vízmolekulák véletlenszerű mozgása kerül előtérbe, a diffúziósúlyozott (DW) MRIjelintenzitás csökkenést jelez, míg azokban a szöveti struktúrákban, ahol a vízmolekulák relatíve helyhez kö-töttek, ott jelintenzitás-fokozódás észlelhető.…”

Imaging Anatomy of Waldeyer's Ring and PET/CT and MRI Findings of Oropharyngeal Non-Hodgkin's Lymphoma

“…Imaging Anatomy of Waldeyer's Ring and PET/CT and MRI Findings of Oropharyngeal Non-Hodgkin's Lymphoma Chun-Xing Zhang 1,2 , Long Liang 1,3 , Bin Zhang 1,3 , Wen-Bo Chen 1 , Hong-Jun Liu 1 , Chun-Ling Liu 1 , Zheng-Gen Zhou 1 , Chang-Hong Liang 1 , Shui-Xing Zhang 1 * towards the NHL diagnosis, but the NHL's imaging findings lacked the specificity (Ito et al, 2012;Loggers et al, 2014). The conventional computed tomography (CT) had certain advantages in displaying the tumor location, size and calcification situation of ONHL, but when used to determine whether the local lesion mucosa was destructed, as well as the violation degrees of surrounding tissues, its limitations were significant (Wolach et al, 2014). Magnetic resonance imaging (MRI) could perform the multi-dimensional imaging, which was conducive to display the location, scope and size of the lesion, and because of its high resolution towards the soft tissues, it could clearly exhibit whether the local lesion mucosa was destructed, as well as the signal characteristics of soft tissue mass.…”