What is the role of FDG-PET scans in thoracic non-Hodgkin lymphoma (NHL) imaging?

Updated: Mar 05, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

FDG-PET scanning can be used to differentiate between fibrosis and viable tumor. In patients with lymphoma, 30-64% have a residual mass after the completion of therapy. FDG accumulates in viable tumor, but it does not accumulate in fibrotic or necrotic tissue.

In a study by Sasaki and colleagues, the authors concluded that in the accurate detection of malignant lymphoma, FDG-PET scanning offers more information in addition to the findings of conventional diagnostic methods than does 67Ga scintigraphy. [17]

Kostakoglu and colleagues compared the accuracy of FDG-PET and 67Ga scanning in the identification of disease sites in patients with HD or with intermediate- or high-grade NHL at initial diagnosis or clinical recurrence. [18] The report indicated that in imaging aggressive lymphoma and HD before treatment, the site and patient sensitivity of FDG-PET scanning is significantly greater than that of 67Ga scintigraphy.

Preliminary results from a study by Schillaci and co-authors indicated that in untreated patients, 99mTc tetrofosmin scintigraphy effectively depicts supradiaphragmatic lymphoma lesions. [33] The report suggested that serial scintigraphic studies may be useful in the monitoring of treatment response, but it also stated that larger series would be required to better elucidate 99mTc tetrofosmin scintigraphy's possible role in such monitoring.


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