Hodgkin's Disease Research Today is a free monthly online journal that collates and summarizes the latest research about Hodgkin's Disease, including details on causes, cancer, lymphoma, stages, symptoms. | ||||||||
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Comparison of gallium and PET scans at diagnosis and follow-up of pediatric patients with Hodgkin lymphoma.Hines-Thomas M, Kaste SC, Hudson MM, Howard SC, Liu WA, Wu J, Kun LE, Shulkin BL, Krasin MJ, Metzger ML University of Tennessee School of Medicine, Memphis, Tennessee, USA. BACKGROUND: Positron emission tomography (PET) and gallium scans facilitate diagnosis and staging, evaluation of response to therapy, and monitoring for relapse in Hodgkin lymphoma (HL), but have not been compared in pediatric HL. PROCEDURE: We performed concurrent PET and gallium scans on 44 pediatric HL patients at diagnosis, early response, off chemotherapy, and off-therapy evaluations. PET and gallium scans were compared to each other and to computed tomography (CT) alone to determine whether either modality led to a change in stage or modified the results of the early response evaluation, which was used to determine the radiation dose. RESULTS: PET upstaged four patients at diagnosis (2 from stage I to II, one II to III, and one III to IV), but did not lead to a change in therapy in any of them. It changed response category in two patients at early response evaluation, leading to a change in radiation dose for 1 patient (25.5 Gy instead of 15 Gy to the spleen). Gallium did not change the stage of treatment for any patient. The negative predictive values for eventual lymphoma relapse of PET and gallium scans at off therapy were 89% and 83%, respectively; the positive predictive value of PET at off therapy is 29%. CONCLUSION: PET appears to be superior to gallium in pediatric HL; future studies will determine the optimal timing of PET to assess early response and the utility of quantitative interpretation of the avidity of specific nodal sites. Published 12 June 2008 in Pediatr Blood Cancer, 51(2): 198-203.
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