Document Detail


Nodal status of malignant lymphoma in pelvic and retroperitoneal lymphatic pathways: comparison of integrated PET/CT with or without contrast enhancement.
MedLine Citation:
PMID:  17904324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 ((18)FDG) 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.
Authors:
Tsuyoshi Morimoto; Ukihide Tateishi; Tetsuo Maeda; Yasuaki Arai; Yasuo Nakajima; E Edmund Kim
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-09-27
Journal Detail:
Title:  European journal of radiology     Volume:  67     ISSN:  0720-048X     ISO Abbreviation:  Eur J Radiol     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-18     Completed Date:  2009-01-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  508-13     Citation Subset:  IM    
Affiliation:
Division of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Contrast Media*
Female
Humans
Lymphoma / diagnosis*
Male
Middle Aged
Pelvis / radiography,  radionuclide imaging
Positron-Emission Tomography / methods*
Reproducibility of Results
Retroperitoneal Space / radiography,  radionuclide imaging
Sensitivity and Specificity
Subtraction Technique
Systems Integration
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media

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