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Published in: European Journal of Nuclear Medicine and Molecular Imaging 9/2005

01-09-2005 | Original Article

67Ga-SPECT/CT with a hybrid system in the clinical management of lymphoma

Authors: Barbara Palumbo, Silvio Sivolella, Isabella Palumbo, Anna Marina Liberati, Renato Palumbo

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 9/2005

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Abstract

Purpose

The purpose of this study was to investigate the added value of co-registered fusion imaging using a hybrid system in patients with lymphoma.

Methods

Twenty-four lymphoma patients underwent 67Ga-SPECT/CT using a hybrid tomograph consisting of a dual-head, variable-angle gamma camera and a low-dose X-ray tube. Results were compared with those of SPECT alone.

Results

Forty-five lesions were identified by SPECT alone, while 49 were detected by SPECT/CT. Forty out of the 45 lesions observed on SPECT were confirmed as lymphoma, but five were due to other causes (thoracic aorta blood pool activity, sialoadenitis in the submandibular gland, bowel activity, rib fracture and bone marrow activation due to radiotherapy). SPECT/CT identified nine more neoplastic lesions compared with SPECT alone: four areas of radiopharmaceutical accumulation were observed in para-aortic lymph nodes, three in the spleen, one in the liver and one in para-iliac lymph nodes. In five cases, SPECT/CT provided additional anatomical information over SPECT alone. In four patients, four large areas of 67Ga uptake (one mediastinal, two supraclavicular and one para-aortic) were better characterised; in one subject uptake was localised in the seventh thoracic vertebra only by SPECT/CT. Hybrid imaging provided additional data in 13 patients (54.2%), thus inducing oncologists to reconsider the therapeutic approach in eight subjects (33.2%): unnecessary treatment was avoided in four (16.6%) while therapy was altered in another four (16.6%).

Conclusion

SPECT/CT hybrid system is able to provide information not obtained by SPECT alone. It allows the anatomical localisation of lymphoma and physiological radiopharmaceutical uptake, facilitates the diagnosis of tumours located in the abdomen (subdiaphragmatic lesions) and provides information that may cause a change in therapeutic strategy.
Literature
1.
go back to reference Vinnicombe SJ, Reznek RH. Computerized tomography in the staging of Hodgkin’s disease and non-Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S42–55PubMed Vinnicombe SJ, Reznek RH. Computerized tomography in the staging of Hodgkin’s disease and non-Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S42–55PubMed
2.
go back to reference Rankin SC. Assessment of response to therapy using conventional imaging. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S56–64PubMed Rankin SC. Assessment of response to therapy using conventional imaging. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S56–64PubMed
3.
go back to reference Sapir EE, Israel O. Gallium-67 scintigraphy: a cornerstone in functional imaging of lymphoma. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S65–81PubMed Sapir EE, Israel O. Gallium-67 scintigraphy: a cornerstone in functional imaging of lymphoma. Eur J Nucl Med Mol Imaging 2003;30 Suppl 1:S65–81PubMed
4.
go back to reference Castellani MR, Cefalo G, Terenziani M, Aliberti G, Maccauro M, Alessi A, et al. Gallium scan in adolescents and children with Hodgkin’s disease (HD): treatment response assessment and prognostic value. Q J Nucl Med 2003;47(1):22–30PubMed Castellani MR, Cefalo G, Terenziani M, Aliberti G, Maccauro M, Alessi A, et al. Gallium scan in adolescents and children with Hodgkin’s disease (HD): treatment response assessment and prognostic value. Q J Nucl Med 2003;47(1):22–30PubMed
5.
go back to reference Front D, Bar-Shalom R, Mor M, Haim N, Epelbaum R, Frenkel A, et al. Hodgkin disease: prediction of outcome with 67Ga scintigraphy after one cycle of chemotherapy. Radiology 1999;210:487–91PubMed Front D, Bar-Shalom R, Mor M, Haim N, Epelbaum R, Frenkel A, et al. Hodgkin disease: prediction of outcome with 67Ga scintigraphy after one cycle of chemotherapy. Radiology 1999;210:487–91PubMed
6.
go back to reference Front D, Bar-Shalom R, Mor M, Haim N, Epelbaum R, Frenkel A, et al. Aggressive non-Hodgkin lymphoma: early prediction of outcome with 67Ga scintigraphy. Radiology 2000;214:253–7PubMed Front D, Bar-Shalom R, Mor M, Haim N, Epelbaum R, Frenkel A, et al. Aggressive non-Hodgkin lymphoma: early prediction of outcome with 67Ga scintigraphy. Radiology 2000;214:253–7PubMed
7.
go back to reference Bar-Shalom R, Mor M, Yefremov N, Goldsmith SJ. The value of Ga-67 scintigraphy and F-18 fluorodeoxyglucose positron emission tomography in staging and monitoring the response of lymphoma to treatment. Semin Nucl Med 2001;31:177–90PubMed Bar-Shalom R, Mor M, Yefremov N, Goldsmith SJ. The value of Ga-67 scintigraphy and F-18 fluorodeoxyglucose positron emission tomography in staging and monitoring the response of lymphoma to treatment. Semin Nucl Med 2001;31:177–90PubMed
8.
go back to reference Kostakoglu L, Goldsmith SJ. Positron emission tomography in lymphoma: comparison with computed tomography and gallium-67 single photon emission computed tomography. Clin Lymphoma 2000;1:67–74PubMed Kostakoglu L, Goldsmith SJ. Positron emission tomography in lymphoma: comparison with computed tomography and gallium-67 single photon emission computed tomography. Clin Lymphoma 2000;1:67–74PubMed
9.
go back to reference Chajari M, Lacroix J, Peny AM, Chesnay E, Batalla A, Henry-Amar M, et al. Gallium-67 scintigraphy in lymphoma: is there a benefit of image fusion with computed tomography? Eur J Nucl Med Mol Imaging 2002;29:380–7CrossRefPubMed Chajari M, Lacroix J, Peny AM, Chesnay E, Batalla A, Henry-Amar M, et al. Gallium-67 scintigraphy in lymphoma: is there a benefit of image fusion with computed tomography? Eur J Nucl Med Mol Imaging 2002;29:380–7CrossRefPubMed
10.
go back to reference Keidar Z, Israel O, Krausz Y. SPECT/CT in tumour imaging: technical aspects and clinical applications. Semin Nucl Med 2003;33 3:205–18CrossRefPubMed Keidar Z, Israel O, Krausz Y. SPECT/CT in tumour imaging: technical aspects and clinical applications. Semin Nucl Med 2003;33 3:205–18CrossRefPubMed
11.
go back to reference Israel O, Yefremov N, Mor M, Haim N, Gaitini D, Epelbaum R, et al. A new technology of combined transmission (CT) and emission (67Ga) tomography (TET) in the evaluations of patients with lymphoma (abstract). J Nucl Med 2000;41:70p Israel O, Yefremov N, Mor M, Haim N, Gaitini D, Epelbaum R, et al. A new technology of combined transmission (CT) and emission (67Ga) tomography (TET) in the evaluations of patients with lymphoma (abstract). J Nucl Med 2000;41:70p
12.
go back to reference Israel O, Yefremov N, Mor M, Epelbaum R, Dann EJ, Gaitini D, et al. Combined transmission (CT) and Ga-67 emission tomography (TET) in the evaluation of response to treatment and diagnosis of recurrence in patients with lymphoma (abstract). Eur J Nucl Med 2000;27:1160 Israel O, Yefremov N, Mor M, Epelbaum R, Dann EJ, Gaitini D, et al. Combined transmission (CT) and Ga-67 emission tomography (TET) in the evaluation of response to treatment and diagnosis of recurrence in patients with lymphoma (abstract). Eur J Nucl Med 2000;27:1160
13.
go back to reference Sivolella S, Palumbo B, Palumbo I, Liberati AM, Moschini TO, Fiorucci G, et al. Usefulness of SPECT/CT with Ga-67 in evaluating patients with lymphoma (abstract). Q J Nucl Med Mol Imaging 2004;48(1):34 Sivolella S, Palumbo B, Palumbo I, Liberati AM, Moschini TO, Fiorucci G, et al. Usefulness of SPECT/CT with Ga-67 in evaluating patients with lymphoma (abstract). Q J Nucl Med Mol Imaging 2004;48(1):34
14.
go back to reference Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, et al. 67Ga scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging 2003;30(12):BP125–31PubMed Bombardieri E, Aktolun C, Baum RP, Bishof-Delaloye A, Buscombe J, Chatal JF, et al. 67Ga scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging 2003;30(12):BP125–31PubMed
15.
go back to reference Schillaci O, Danieli R, Manni C, Simonetti G. Is SPECT/CT with a hybrid camera useful to improve scintigraphic imaging interpretation? Nucl Med Commun 2004;25(7):705–10CrossRefPubMed Schillaci O, Danieli R, Manni C, Simonetti G. Is SPECT/CT with a hybrid camera useful to improve scintigraphic imaging interpretation? Nucl Med Commun 2004;25(7):705–10CrossRefPubMed
16.
go back to reference Schillaci O. Functional–anatomical image fusion in neuroendocrine tumors. Cancer Biother Radiopharm 2004;19(1):129–34CrossRefPubMed Schillaci O. Functional–anatomical image fusion in neuroendocrine tumors. Cancer Biother Radiopharm 2004;19(1):129–34CrossRefPubMed
17.
go back to reference Schillaci O, Danieli R, Manni C, Capoccetti F, Simonetti G. Technetium-99m-labelled red blood cell imaging in the diagnosis of hepatic haemangiomas: the role of SPECT/CT with a hybrid camera. Eur J Nucl Med Mol Imaging 2004;31:1011–5CrossRefPubMed Schillaci O, Danieli R, Manni C, Capoccetti F, Simonetti G. Technetium-99m-labelled red blood cell imaging in the diagnosis of hepatic haemangiomas: the role of SPECT/CT with a hybrid camera. Eur J Nucl Med Mol Imaging 2004;31:1011–5CrossRefPubMed
18.
go back to reference Tharp K, Israel O, Hausmann J, Bettman L, Martin WH, Daitzchman M, et al. Impact of 131I-SPECT/CT images obtained with an integrated system in the follow-up of patients with thyroid carcinoma. Eur J Nucl Med Mol Imaging 2004;31:1435–42CrossRefPubMed Tharp K, Israel O, Hausmann J, Bettman L, Martin WH, Daitzchman M, et al. Impact of 131I-SPECT/CT images obtained with an integrated system in the follow-up of patients with thyroid carcinoma. Eur J Nucl Med Mol Imaging 2004;31:1435–42CrossRefPubMed
Metadata
Title
67Ga-SPECT/CT with a hybrid system in the clinical management of lymphoma
Authors
Barbara Palumbo
Silvio Sivolella
Isabella Palumbo
Anna Marina Liberati
Renato Palumbo
Publication date
01-09-2005
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 9/2005
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-005-1788-x

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