Impact of PET-CT on involved field radiotherapy design for pediatric Hodgkin lymphoma

Arnold C. Paulino, Judith Margolin, Zoann Dreyer, Bin S. Teh, Stephen Chiang

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

Purpose: To determine how the incorporation of PET-CT changes radiotherapy treatment in pediatric Hodgkin lymphoma. Procedure: Fifty-three Hodgkin lymphoma patients with a median age of 14 years (6-21 years) underwent multiagent chemotherapy followed by involved field radiotherapy (IFRT) to initial sites of disease. All patients had conventional staging which included CT scan of the neck, chest, abdomen and pelvis, bone marrow biopsy±MRI, Gallium scan and bone scan. All had an initial 18-F-fluoro-deoxy-D-glucose (FDG) PET-CT. When there was discordance between conventional staging and PET-CT staging, true sites of disease were determined either by biopsy or response to multiagent chemotherapy. Results: In 19 of 53 (35.8%) patients, there was discordance between conventional staging and PET-CT findings. The most common location for the 23 sites of discordance were the spleen in 6 (26.1%), neck in 3 (13%), inguinal nodes in 3 (13%) and mediastinum in 3 (13%). A change in stage occurred in 5 (9.4%) as a result of PET-CT imaging. A change in IFRT fields occurred in 9 (17%); eight were more extensive while one was less extensive. For PET-CT, the specificity, sensitivity, positive predictive value and accuracy were 99.5%, 96.3%, 97.9%, and 98.9%. Conclusion: Incorporation of PET-CT information was found to influence IFRT design in 17% of patients, with most having more extensive radiotherapy fields.

Original languageEnglish (US)
Pages (from-to)860-864
Number of pages5
JournalPediatric Blood and Cancer
Volume58
Issue number6
DOIs
StatePublished - Jun 2012

Keywords

  • Hodgkin disease
  • Lymphoma
  • Pediatric cancer
  • PET-CT
  • Radiotherapy planning

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Fingerprint

Dive into the research topics of 'Impact of PET-CT on involved field radiotherapy design for pediatric Hodgkin lymphoma'. Together they form a unique fingerprint.

Cite this