PURPOSE: To retrospectively compare fluorine 18 fluorodcoxyglucose (FDG) positron emission lomographic (PET) and computed tomographic (CT) findings at the same anatomic locations in patients with lymphoma by using a combined PET/CT scanner and to analyze the lesions on metabolic and anatomic bases to evaluate causes of discrepant findings between the two modalities.
MATERIALS AND METHODS: The institutional review board dllowed an exempt retrospective review of cancer PET database, and informed consent was waived. The study was HIPAA compliant. Fifty-three patients with lymphoma (20 Hodgkin and 33 non-Hodgkin; mean age, 43 years; range, 12-83 years) who underwent FDC PFT/CT were included. The PET and CT images were interpreted by two nuclear medicine physicians and one radiologist, respectively, blinded to the other imaging findings. Concordant PET and CT findings were regarded as positive or negative for lymphoma. The site with discordant findings was defined as positive for disease it it was accompanied by other PET- and CT-positive sites in the same patient or was confirmed clinically (histologic examination or progressive disease). Staging results were also compared by one nuclear medk ine physician.
RESULTS: Of a total of 1537 anatomic sites in 53 patients, 48 had discordant findings between PET and C I. Forty (83%) of the 48 sites had correct PET findings (31 positive, nine negative), five had correct CT findings, and three were unresolved. The 31 PET-positive and CT-negative sites accounted for 23% of all 134 true-posilive PET sites. PET provided accurate staging in an incremental nine (17%, upstaging in four and downstaging in five) of 53 patients in whom CI staging was incorrect. CT provided correct upstaging in two patients.
CONCLUSION: FDC PET/CT as a combined modality may contribute substantially to lesion characterization and staging in patients with lymphoma.