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Comparison of 18F-FDG-PET and standard procedures for the pretreatment staging of children and adolescents with Hodgkin’s disease

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to perform a prospective, blinded comparison of 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and conventional staging methods (CSMs) for initial staging of children and adolescents with Hodgkin’s disease (HD).

Methods

Over a period of 4 years, 55 children and adolescents with HD (mean age 15.5 years, range 3.9–18.9 years) were prospectively recruited into the study. They underwent 61 FDG-PET studies using a dedicated whole-body PET scanner as a part of their initial staging work-up. PET findings were correlated with the results of CSMs, including computed tomography (CT), ultrasound, bone scanning and bone marrow examination. Discordant findings were resolved by magnetic resonance imaging or clinical follow-up (range 2–47 months).

Results

PET correctly changed the staging in 15% of patients (seven upstagings, two downstagings). Only two out of 61 patients (3%) were not accurately staged by PET; in these children, PET missed small lymphoma nodules detected on lung CT. The sensitivity of PET and CSMs for pretreatment staging was 96.5% and 87.5%, respectively; specificity was 100% and 60%, and accuracy, 96.7% and 85.2%, respectively. Upon combination of FDG-PET and lung CT, the diagnostic accuracy reached 100% in our series.

Conclusion

Our study showed that whole-body FDG-PET is an efficient and useful method for the initial staging of children with HD. FDG-PET in combination with lung CT should be recommended as a screening method prior to other conventional imaging modalities to plan a rational staging protocol. Large multicentre prospective studies are necessary to verify this conclusion.

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Acknowledgement

This work was supported by grant NC/7568-3 from the Internal Grant Agency of the Ministry of Health of the Czech Republic.

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Authors and Affiliations

  1. Department of Paediatric Haematology and Oncology, Charles University 2nd Medical School, V Uvalu 84, 150 06, Prague 5, Czech Republic

    Edita Kabickova, David Sumerauer, Eva Drahokoupilova, Michaela Nekolna & Marketa Chanova

  2. Department of Radiological Techniques, Charles University 2nd Medical School, V Uvalu 84,, 150 06, Prague 5, Czech Republic

    Eliska Cumlivska

  3. Department of Medical Informatics, Prague, Charles University 2nd Medical School, V Uvalu 84, 150 06, Prague 5, Czech Republic

    Marie Hladikova

  4. Department of Pathology and Molecular Medicine, Charles University 2nd Medical School, V Uvalu 84, 150 06, Prague 5, Czech Republic

    Roman Kodet

  5. Department of Nuclear Medicine, Na Homolce Hospital, Roentgenova 2, 150 03, Prague 5, Czech Republic

    Otakar Belohlavek

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  1. Edita Kabickova
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  2. David Sumerauer
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  7. Marie Hladikova
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Correspondence to Edita Kabickova.

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Kabickova, E., Sumerauer, D., Cumlivska, E. et al. Comparison of 18F-FDG-PET and standard procedures for the pretreatment staging of children and adolescents with Hodgkin’s disease. Eur J Nucl Med Mol Imaging 33, 1025–1031 (2006). https://doi.org/10.1007/s00259-005-0019-9

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  • DOI: https://doi.org/10.1007/s00259-005-0019-9

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