PET/CT in initial staging and therapy response assessment of early mediastinal lymphoma

Abstract

Objective: To detect accuracy of PET/CT in the initial staging, response after the first line and end of treatment in early mediastinal lymphoma patients compared to contrast CT. Materials and methods: We studied 50 patients with pathologically proven lymphoma with a mean age = 27.5. All patients were at early stage. All patients performed CT and PET/CT for initial staging, after the first course of chemotherapy (after 4–6 weeks) and at the end of treatment (after 2–4 months). Results: PET/CT upstaged 5 cases. At first line of treatment, PET/CT and CECT were agreeable in 32% of cases. PET/CT showed 100% sensitivity, 96.7% specificity, 95% positive predictive value and 100% negative predictive value. At the end of treatment both methods showed a 46% agreement. PET/CT was statistically significant in the follow up of hilar and axillary lymph nodes. PET/CT showed 100% sensitivity and specificity; compared to 62.5% sensitivity and 97.6% specificity for CECT in detection of extra-nodal disease sites. Conclusion: PET/CT proved higher sensitivity and specificity over CECT. The major strength of PET/CT over CECT was its higher ability for detection of extra-nodal sites of lymphoma and excluding active disease in residual nodal mass lesions on follow up.

Keywords

• PET/CT
• Hodgkin’s lymphoma
• Non-Hodgkin’s lymphoma
• Mediastinum
• Therapy response