الفهرس 
CT Anatomical Consideration of Lymphatic SystemOnly 14 pages are availabe for public view
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Abstract
FDG-PET is superior to Gallium in imaging lymphoma in that it has better site sensitivity 100% Vs 71.5%. FDG PET upstaged 25% patients when compared to Ga scintigraphy. (Okada M et al, 2010)
FDG-PET is much easier to be performed than gallium as the examination takes about 1 hour only, while there is a delay of 3 days after gallium injection before scanning is to be performed. (Richard T. et al, 2007)
FDG has a further advantage over gallium 67 in terms of the effective dose; FDG results in an effective dose of 5-10 mSv, depending on applied adult dose (5-10 mCi). While Gallium due to its long half life delivers a high radiation dose of average 44 mSv per standard injection of 10mCi. (Richard T. et al, 2007)
The addition of CT for anatomic correlation in the newer PET/CT systems has improved staging sensitivity and specificity. In a recent systematic review, the overall sensitivity and specificity of FDG PET/CT for initial staging of NHL and Hodgkin disease were 97% and 100%, respectively. (Kwee TC et al, 2008)
In recent reviews, use of PET/CT resulted in upstaging in 7.5%–31.0% of cases and in down staging in 1.0%–9.6%. (Okada M et al, 2010)
The reported pooled sensitivity & specificity for the detection of residual disease after completion of first-line therapy are: 84% & 90%, respectively, for Hodgkin disease and 72% & 100%, respectively, for aggressive NHL.
The advantages of FDG PET/CT are mostly attributed to; (A)Detection of FDG-avid “small-sized” lymph nodes (usually <1 cm, which are considered normal in other modalities).(B)Detection of extra nodal sites that were previously missed at CT most commonly cortical bone, bone marrow, skin and liver &spleen(non enhanced CT). (C)Benign lesions detected on CT as Para-spinal and pulmonary lesions, found to be malignant at FDG PET/CT.(D)FDG PET/CT is extremely useful to differentiate between residual tumor and fibrotic tissue during the course of chemotherapy, thereby providing a more accurate diagnosis than does either CT or magnetic resonance (MR) imaging in terms of extent of residual disease. (Bar-Shalom R et al, 2003)
Recommendations of FDG PET usage: It is definitely recommended in; (A) Initial staging in patients with Hodgkin’s lymphoma (HL), diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). (B) Restaging at completion of therapy in Hodgkin’s lymphoma, diffuse large B-cell lymphoma and follicular lymphoma. (M. Ansell & James O. Armitage, 2012).
Recommendations of FDG PET usage: It is probably indicated in; (A) staging in patients with peripheral T-cell lymphoma and mantle cell lymphoma. (B) Interim response assessment in patients with HL and DLBCL. (C) Restaging at completion of therapy in PTCL and MCL. (D) Detection of potential sizes of transformation. (M. Ansell & James O. Armitage, 2012).
Recommendations of FDG PET usage: It is not recommended in; monitoring of patients for relapse. (MAnsell & James O. Armitage, 2012).