Low-Dose PET/CT and Full-Dose Contrast-Enhanced CT at the Initial Staging of Localized Diffuse Large B-Cell Lymphomas

Area of Science:

• Oncology
• Radiology
• Nuclear Medicine

Background:

• Computed tomography (CT) has been the standard for diffuse large B-cell lymphoma (DLBCL) staging.
• Positron emission tomography (PET)/CT is increasingly used, but its role versus traditional CT requires clarification.

Purpose of the Study:

• To compare the diagnostic performance of 2-deoxy-2-((18)F)fluoro-d-glucose ((18)F-FDG) PET/CT and contrast-enhanced CT (ceCT) for staging localized DLBCL.
• To evaluate if PET/CT can replace ceCT in DLBCL staging.

Main Methods:

• Retrospective analysis of 28 patients with localized DLBCL.
• Comparison of nodal and extranodal lesion detection between low-dose (18)F-FDG PET/CT and full-dose ceCT.
• Assessment of staging concordance and impact on treatment management.

Main Results:

• PET/CT detected more involved nodal (41 vs. 36) and extranodal (16 vs. 15) regions than ceCT.
• Staging concordance was 79% (22/28 patients), with discordant findings altering treatment in 11% (3/28 patients).
• PET/CT provided a more comprehensive staging and therapeutic approach.

Conclusions:

• Low-dose (18)F-FDG PET/CT is effective for staging localized DLBCL.
• (18)F-FDG PET/CT offers improved lesion detection and staging accuracy compared to ceCT.
• PET/CT can potentially obviate the need for additional ceCT in DLBCL staging.