ISSN:
1569-8041
Keywords:
computed tomography
;
gallium scan
;
magnetic resonance
;
mediastinal Hodgkin's disease
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Background: In patients with Hodgkin's disease, the use of gallium-67scintigraphy (Ga-67) compared to conventional staging and restaging techniquesis still controversial. In particular, in a combined modality treatment withchemotherapy and radiotherapy given in sequence, its role in detecting activedisease after chemotherapy may be useful in planning the subsequentradiotherapeutic strategy. Patients and methods: From March 1990 to September 1994, 125 patientswith previously untreated histologically proven Hodgkin's disease wereenrolled in two different prospective trials according to clinical stage.Staging procedures included Ga-67, chest-abdominal computed tomography (CT),and/or magnetic resonance (MR). All three tests were performed in 53patients at staging and in 47 at restaging. Results of Ga-67 at staging werecompared to conventional procedures or pathological findings. Results ofGa-67, CT scan, and MR at restaging were compared to disease outcome duringthe follow-up. Finally a cost/benefit ratio for each test was determined. Results: At staging, Ga-67 showed lower sensitivity than CT and MR(90 vs. 96 and 100%, respectively) because of the number offalse-negative images. Nevertheless, by using both CT and Ga-67 scan, thesensitivity is equal to that observed with MR (100%). At restaging,Ga-67 is superior to CT scan and equivalent to MR in detecting true negativepatients (specificity: 98% vs. 45% vs. 92%). Conclusions: As a single technique, Ga-67 scan cannot substitute forCT scan or MR in staging patients with Hodgkin's disease. Nevertheless, Ga-67scan has an important role in defining complete remission after treatment andtherefore in planning subsequent treatment. Considering the lower costs of CTscan plus Ga-67 ($320) versus MR alone ($810), the twotests may be considered procedures of choice in staging as well as inrestaging patients with Hodgkin's disease.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1023/A:1008249700499
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