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J Nucl Med. 2008; 49 (Supplement 1):340P
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Oncology-Clinical Diagnosis: Hematologic Tumors

Hematology Malignancy

Comparison of FDG-PET, FDG-PET/CT, contrast-enhanced CT (CECT), and low dose non-contrast CT (NCCT) imaging of diffuse large B-cell lymphoma (DLBCL)

Elise Chong1, Kimberly Coughlan1, Anthony Mato1, Kalpana Vuppali1, Stephen Schuster1, Abass Alavi1 and Drew Torigian1

1 University of Pennsylvania, Philadelphia, Pennsylvania

1438

Objectives: We compared low-dose NCCT, FDG-PET, PET/CT, and CECT for detection of nodal and extranodal sites of disease in DLBCL.

Methods: We included 15 subjects with diagnosis of DLBCL who had FDG-PET/CT and CECT within 6 weeks of each other with no intervening therapy. Radiologists retrospectively and blindly interpreted low dose NCCT and PET portions of PET/CT separately, followed by PET/CT together, and lastly CECT. Presence or absence of disease at 42 nodal and 52 extranodal pre-specified sites of disease was recorded for each test.

Results: 152 positive sites were detected on matched studies from 15 subjects. See table below:


Figure 1

Low dose NCCT was inferior for detection of nodal sites of disease, particularly in mediastinal and mesenteric locations. PET, PET/CT, and CECT were comparable for detection of nodal involvement. Of nodal sites detected, paraaortic nodes were detected more frequently on CECT (12 sites) as compared to PET (2 sites) and PET/CT (3 sites), whereas pelvic side wall and inguinal nodes were detected more frequently on PET (7 sites) and PET/CT (6 sites) as compared to CECT (2 sites). With regard to extranodal sites, bone marrow involvement was detected only by PET (3 sites) and PET/CT (3 sites).

Conclusions: These data are the first assessment of low-dose NCCT to assess burden of disease in DLBCL. Although low dose NCCT is associated with lower radiation exposure, it cannot substitute for CECT in detection of DLBCL. The combination of PET or PET/CT and CECT maximizes the number of disease sites detected in DLBCL.





This Article
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Right arrow Articles by Torigian, D.
PubMed
Right arrow Articles by Chong, E.
Right arrow Articles by Torigian, D.