Comparison of 18F-FDG PET/CT and CT: Diagnosis
Performance in Lymphoma Patient after Treatment
Sunanta Chiewvit MD*, Kullathorn Thephamongkhol MD**,
Kritaya Ubolnuch MNS*, Julaporn Pooliam MSc***,
Nopparat Phongsawat BSc*, Pipat Chiewvit MD****
Affiliation :
* Division of Nuclear Medicine, Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Division of Radiotherapy, Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
*** Clinical Epidemiology Unit, Office for Research and Development, Faculty of Medicine Siriraj Hospital,
Mahidol University, Bangkok, Thailand
**** Division of Diagnosis Radiology, Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : Retrospectively comparing 18F-FDG PET/CT and CT findings at the same anatomic locations in patients with
lymphoma by using a combined PET/CT scanner and to analyze the lesions on both metabolic and anatomic bases to
evaluate their sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. We
analyzed all studies, all patients, common cell type in this study such as diffuse large B cell lymphoma (DLBCL) and
Hodgkin’s lymphoma and indication of the study such as restaging for recurrence post-therapy and evaluate residual disease
within two months after chemotherapy.
Material and Method: Sixty-seven lymphoma patients were studied PET/CT between January 2007 and December 2012
in Siriraj Hospital. We excluded six patients due to no medial report in our hospital. Sixty-one patients (29 male, 32 female,
mean age 46.617.7 years, range 8-75) with NHL and with HL) were analyzed for the result of dual-modality PET/CT. They
underwent 77 18F-FDG PET/CT studies for restaging, for recurrence post-therapy based on 41 studies and evaluation of
residual disease within two months after chemotherapy in 36 studies.
Results : The statistical parameters of 18F-FDG PET/CT imaging of lymphoma patients after treatment show significantly
better specificity than CT and insignificant high accuracy for all studies, all patients, histology of DLBCL, indication of
evaluation of active lymphoma within two months after chemotherapy. The 18F-FDG PET/CT parameters of accuracy and
PPV are higher than CT without statistical significance. The 18F-FDG PET/CT is not significantly better than CT for histology
of Hodgkin’s lymphoma and indication of restaging for recurrence post-therapy. Nevertheless, the 18F-FDG PET/CT shows
slightly improved specificity, PPV, and accuracy than CT. The sensitivity of CT in this study is high and may be from most
of our cases selected post-treatment lymphoma that had a residual mass after treatment. Therefore, the sensitivity of PET
scan is not significantly higher when compared with CT scan.
Conclusion : The PET/CT is better than CT for post-treatment lymphoma patient particularly for cell type of DLBCL and
indication for evaluation of active lymphoma within two months after chemotherapy.
Keywords : 18F-FDG PET/CT, Lymphoma
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