PET-CT with intravenous contrast in the evaluation of patients with lymphoma. contribution to diagnostic indications

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• 作者：M.P. Talavera Rubio^a ; ^{mdtalavera@sescam.jccm.es} ; A.M. Garc&#237 ; a Vicente^a ; E. Dom&#237 ; nguez Ferreras^b ; C. Calle Primo^c ; V.M. Poblete Garc&#237 ; a^a ; B. Herná ; ndez Ruiz^c ; M. Belló ; n Guardia^a ; A. Palomar Muñ ; oz^a ; I. Cepedello Boiso^a ; P. Pilkington Woll^a ; B. Gonzá ; lez Garc&#237 ; a^a ; J.M. Cordero Garc&#237 ; a^a ; C. Molino Trinidad^b ; A. Soriano Castrejó ; n^a
• 关键词：Lymphoma ; PET-CT ; Intravenous contras
• 刊名：Revista Espa?ola de Medicina Nuclear (English Edition)
• 出版年：2009
• 出版时间：September-October 2009
• 年：2009
• 卷：28
• 期：5
• 页码：235-241
• 全文大小：245 K

文摘

Aim

To define the utility of the intravenous contrast administration in the PET-CT (PET-CTc) in patients with lymphoma in order to determine its possible indications.

Material and methods

78 patients with lymphoma were prospectively evaluated. All underwent simultaneous PET-CTc scans in a hybrid system for staging (8), evaluation of response to treatment (29), suspicious of recurrence (9) and complete remission control (48). The PET scan was acquired by a conventional method and the diagnostic CT scan was performed according to radiological protocol.

Both examinations were evaluated blinded and independently, analyzing 28 anatomical locations in order to determine the degree of agreement. Final diagnosis was established by the clinician based on the histological study, results of other diagnostic technologies or clinical follow-up.

Results

The final results of both technologies were concordant in 87/94 studies (92.5 % ). A total of 158 (36 FP) pathological locations were detected with PET-CT and 189 (71 FP) with CTc, with 72 locations being discordant between both techniques.

Global sensitivity, specificity, PPV and NPV were 93 % , 98 % , 77 % and 99 % ; and 94 % , 97 % , 62 % and 99 % respectively.

Conclusions

Administration of intravenous contrast does not seem to provide any advantage in the determination of nodal and extranodal pathology in patients with lymphoma. The low prevalence of disease probably accounts for the limited PPV of both techniques. An increase of our sample size, with a greater homogeneity of the groups, should offer more reliable results.