الفهرس 
? Radiological Anatomy of the Lymph NodesOnly 14 pages are availabe for public view
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Abstract
Role of PET/CT in Diagnosis and Follow up of Non-Hodgkin Lymphoma and Assessment of Extranodal Lymphoma
Prof. Dr. Abeer Maghawry Abd Elhameed, Dr. Samar Ramzy Ragheb, Maggie Salah Abd Elgawad
Radiodiagnosis Department, Faculty of Medicine, Ain Shams University
ABSTRACT
Background: Malignant lymphoma is the most common hematological malignancy accounts for approximately 8% of all adult malignancies. Lymphomas are broadly divided into Hodgkin lymphoma and non-Hodgkin’s lymphoma. Non-Hodgkin lymphoma accounts for about 5% of all cases of cancer. Non-Hodgkin lymphomas have the vast majority of cases and have a greater predilection to disseminate to extra-nodal sites.
Aim of the work: The aim of this work is to study the role of PET/CT in the diagnosis and follow up of Non-hodgkin lymphoma. The study was conducted on thirty patients where the diagnosis of non-hodgkin lymphoma have been pathologically confirmed, 18 males (60%) and 12 females (40%), their ages are ranged between 19 to 72 years old.
Patients and Methods: All patients were subjected to full history taking, laboratory testing, biopsy and histopathology, CT scan and PET/CT examination. All patients were examined using Siemens Bio-graph true point PET/CT scanner. These dedicated systems integrate a PET scanner with a multi-slice helical CT scanners permit the acquisition of co-registered CT and PET images in one session.
Results: In our study, among the 20 patients referred for follow up assessment, their SUVmax before the follow up PET/CT examination ranged from 3.7 – 34.0, with a significant change (p ≤ 0.046) in their follow up examination with SUVmax ranged from 0.0 – 28.0. In follow up assessment among the 20 patients referred after treatment; CECT showed 4 patients (20%) in complete regression, 13 patients (65%) in stable disease and 1 patient (5%) in progressive disease while PET/CT showed 7 patients (35%) in complete remission, 4 patients (20 %) in partial remission, 0 (0.0%) patients in stationary disease, 9 (45%) patients in progressive disease. Thus, PET/CT was concordant with CECT in 6 (30%) cases and disagreed with CECT in 14 (70%) cases with significance (p ≤ 0.015). Our study demonstrated -in correlation with other studies- that PET/CT is an essential imaging tool for patients with non-hodgkin lymphoma for the initial staging as it is highly sensitive in detecting nodal and extra-nodal sites of involvement.
Conclusion: Staging of non- Hodgkin lymphoma with traditional imaging methods has been based on the morphological imaging techniques where CT is based on lymph node size so it neither identifies malignant involvement in normal-size lymph nodes nor differentiates between malignant and inflammatory enlargement of lymph nodes. PET/CT combines the advantages of the excellent functional information provided by PET and the superb spatial and contrast resolution of CT, PET/CT imaging plays a vital part in the staging procedure, may upstage or pick up occult lesions such as splenic, bone marrow, osseous, and gastrointestinal involvement which may be missed on conventional CT.
Keywords: PET/CT, Non-Hodgkin Lymphoma, Extranodal Lymphoma