PET/CT and contrast-enhanced CT: making a difference in assessment and staging of patients with lymphoma

• Published in: Egyptian journal of radiology and nuclear medicine Vol. 51; no. 1; pp. 213 - 17
• Main Authors: Zytoon, Ashraf Anas, Mohamed, Hala Hafez, Mostafa, Basma Adel Abd Elaziz, Houseni, Mohamed Mohamed
• Format: Journal Article
• Language: English
• Published: Cairo Springer 23-10-2020; Springer Nature B.V; SpringerOpen
• Subjects: 18F-FDG PET/CT: 2-[Fluorine-18] fluoro-2-deoxy-d-glucose positron emission tomography combined to computed tomography; Bone marrow; CECT: contrast-enhanced computed tomography; CT imaging; Dextrose; Diabetes; Diagnosis; Disease; Fluorides; Glucose; Insulin; Lymphoma; Medical imaging; Metabolism; Non-Hodgkin's lymphomas; Patients; PET imaging; Radiation; Tomography; Tumors; Egypt; United States > US
• DOI: 10.1186/s43055-020-00320-0
• EISSN: 2090-4762
• ISSN: 0378-603X

Background The aim of this study is to evaluate the diagnostic performance of contrast-enhanced computed tomography (CECT) and 2-[Fluorine-18] fluoro-2-deoxy-d-glucose positron emission tomography combined to computed tomography (18 F-FDG PET/CT) in assessment of lymphoma. Methods Hundred patients, pathologically proven as lymphoma, were evaluated by CECT and 18F-FDG PET/CT for initial assessment and staging of the disease. The number of lesions and the disease stage detected by each modality was calculated and further analyzed to be compared. Results 18F-FDG PET/CT diagnosed a total number of 545 lymphoma involved regions with sensitivity 96.6%, specificity 98.8%, and accuracy 99% that was higher than CECT which diagnosed a total number of 439 lymphomatous regions with sensitivity 87.5%, specificity 85.7%, and accuracy 88%. Discordant staging by both modalities was found in 23% of the patients. Lymphoma was upstaged by PET/CT in 17% of the patients; with major changes in 12% of them and downstaged in 6% of the patients. Conclusion 18F-FDG PET/CT scan has a better diagnostic performance, represented by sensitivity, specificity, and accuracy, than CECT scan in the initial assessment of lymphoma regarding its nodal and extra-nodal lesions that could lead to alteration of disease staging which in turn markedly affecting the decision of treatment regimens.