Miroslav Herman MD, PhD, Presenter: Nothing to Disclose

Boris Paucek MD, Abstract Co-Author: Nothing to Disclose

Ludek Raida MD, Abstract Co-Author: Nothing to Disclose

Miroslav Myslivecek MD,PHD, Abstract Co-Author: Nothing to Disclose

Tomas Papajik MD, PhD, Abstract Co-Author: Nothing to Disclose

Detection of residual disease following the completion of therapy in Hodgkin's lymphoma patients has an exceptional importance in deciding whether to continue or terminate treatment. MRI and gallium-67 (67Ga) scintigraphy can be used to detect residual active mediastinal tissue. Aims of our study were: 1) To evaluate the influence of individual factors (basic demographic data, basic disease parameters, primary applied treatment) on the probability of detection of an active tumor in abnormal residual mediastinal tissue by MRI and 67Ga scintigraphy. 2) To evaluate the risk of relapse/progression of Hodgkin's lymphoma on the detection of active/inactive mediastinal tissue by MRI and 67Ga scintigraphy. 3) To evaluate congruence of MRI and 67Ga scintigraphy findings. 4) To evaluate the accuracy of MRI and 67Ga scintigraphy to predict clinical relapse/progression of HL.

30 Hodgkin's lymphoma patients with abnormal mediastinal tissue following the completion of treatment were examined by MRI and 67Ga scintigraphy. Positive findings were: high signal intensity on unehanced T2-weighted images on MRI and abnormal accumulation of gallium on scintigraphy or SPECT.

1) The detection of active/inactive mediastinal tissue, by either MRI or scintigraphy, was not influenced by any of the evaluated demographic, tumor, or treatment parameters. 2) A two-year event free survival (EFS) for patients without and with detected active mediastinal tissue by MRI was 100% and 25%, statistically significant (p = 0.0001). The probability of a two-year EFS in cases with negative and positive findings on 67Ga scintigraphy was 88% and 60%, statistically significant (p = 0.015). 3) Discrepant results for mediastinal tissue activity were found in 3 (10%) of the total study group of 30 patients. 4) Sensitivity, specificity, accuracy, positive and negative predictive values were: 100%, 96%, 97%, 75%, 100% for MRI; 68%, 89%, 87%, 40%, 96% for 67Ga scintigraphy.

MRI has higher predictive value than gallium-67 scintigraphy in the detection of active lymphatic mediastinal tissue in Hodgkin's lymphoma patients following the completion of therapy.

Herman, M, Paucek, B, Raida, L, Myslivecek, M, Papajik, T, Comparison of MRI and Gallium Scintigraphy in the Evaluation of Residual Mediastinal Mass in Treated Hodgkin’s Lymphoma.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4409651.html