Furth C, Denecke T, Steffen I, Ruf J, Voelker T, Misch D, Vondran F, Plotkin M, Stöver B, Henze G, Lemke AJ, Amthauer H. Correlative imaging strategies implementing CT, MRI, and PET for staging of childhood Hodgkin disease.
J Pediatr Hematol Oncol 2006;
28:501-12. [PMID:
16912590 DOI:
10.1097/01.mph.0000212962.68007.12]
[Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND
The value of different correlative imaging strategies with F18-fluorodeoxyglucose positron emission tomography (FDG-PET) and conventional imaging modalities (CIM) for initial staging of pediatric Hodgkin disease (HD) was assessed.
METHODS
Thirty-three patients (age, 4 to 18 y) with histologically proven HD underwent initial staging with computed tomography (thorax), magnetic resonance imaging (neck, abdomen, pelvis), and FDG-PET in a prospective study. Image fusion (PET-CIM) was performed using a semiautomatic voxel-based algorithm. Analysis of separate, side-by-side (SBS) and fused PET and CIM was performed evaluating 21 nodal and 6 extranodal regions per patient for presence of lymphoma, applying a 5-point confidence scale. The reference data was clinical follow-up (>12 mo).
RESULTS
Concerning lymph node regions above and below the diaphragm the accuracy of CIM, PET, SBS, and image fusion was 86%, 89%, 94%, 97%, and 94%, 94%, 97%, 98%. In extranodal regions, the accuracy was 96%, 96%, 100%, and 100%. The reviewers' confidence was improved significantly by image fusion. Staging and therapy assignment on the basis of CIM was correctly modified by SBS in 5 and 4, by image fusion in 7 and 5 patients.
CONCLUSIONS
Combined reading of FDG-PET and CIM is crucial for accurate staging in pediatric HD. Image fusion improves the observers' confidence and has impact on the therapeutic management.
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