Nodal status of malignant lymphoma in pelvic and retroperitoneal lymphatic pathways: Comparison of integrated PET/CT with or without contrast enhancement

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• 作者：Tsuyoshi Morimoto ; Ukihide Tateishi ; Tetsuo Maeda ; Yasuaki Arai ; Yasuo Nakajima ; E. Edmund Kim
• 关键词：PET ; PET/CT ; Malignant lymphoma
• 刊名：European Journal of Radiology
• 出版年：2008
• 出版时间：September 2008
• 年：2008
• 卷：67
• 期：3
• 页码：508-513
• 全文大小：317 K

文摘

Aim

To determine the diagnostic accuracy of integrated contrast-enhanced positron emission tomography (PET) and computed tomography (CT), as compared with non-contrasted PET/CT, in evaluating nodal status of malignant lymphoma in pelvic and retroperitoneal lymphatic pathways.

Materials and methods

Sixty-six patients (33 men and 33 women) with malignant lymphoma underwent staging with integrated CT and fluorine-18-fluorodeoxyglucose (¹⁸FDG) PET. Tumor types were diffuse large B-cell lymphoma (n = 26, 39 % ), follicular lymphoma (n = 20, 30 % ), Hodgkin disease (n = 16, 24 % ), and marginal zone B-cell lymphoma (n = 4, 6 % ). Both non-contrasted PET/CT and contrast-enhanced PET/CT images were examined separately by two different qualified physicians for each imaging modality, and nodal status of pelvic and retroperitoneal lymphatic pathways was evaluated. Reference standard included follow-up with clinical, laboratory, and conventional CT findings. We compared diagnostic accuracy retrospectively on basis of per-patient and per-lesion analyses between two modalities using McNemar test, respectively.

Results

Nodal status of pelvic and retroperitoneal lymphatic pathways was more accurately determined on contrast-enhanced PET/CT (n = 52, 79 % ) compared with non-contrasted PET/CT (n = 47, 71 % ). Difference in the accuracy of nodal staging between non-contrasted PET/CT and contrast-enhanced PET/CT was significant (p = 0.048). On basis of per-lesion analysis, contrast-enhanced PET/CT determined more accurately the status of external iliac lymph node (p = 0.002), internal iliac lymph node (p < 0.0001), and common iliac lymph node (p = 0.002) compared with non-contrasted PET/CT. Diagnostic accuracies of paraaortic lymph node, aortocaval lymph node, and paracaval lymph node were similar by either non-contrasted PET/CT or contrast-enhanced PET/CT.

Conclusion

Integrated contrast-enhanced PET/CT improves the diagnostic accuracy in evaluating nodal status of pelvic and retroperitoneal lymphatic pathways in patients with malignant lymphoma.