New diagnostic imaging procedures in Hodgkin's disease

A variety of new diagnostic imaging methods have been developed in recent years for patients with Hodgkin's disease in an attempt to improve the detection of spleen and bone marrow involvement within the scope of staging and to discriminate between fibrosis and vital lymphoma after treatment. Somatostatin receptor scintigraphy has been performed only in a small number of patients to date and further studies must be conducted. Magnetic resonance imaging (MRI), as the established method, has shown its potential in several studies in detecting both spleen and bone marrow involvement; MRI investigations, however, only visualize a limited portion of the body and therefore must be performed in areas of clinically suspected disease. Immunoscintigraphy with radiolabeled antibodies is still in a preclinical or at most early clinical stage of evaluation and first results have to be confirmed in a controlled trial. Positron emission tomography (PET) with [18F]fluorodeoxy-glucose (FDG) is a technique which is still not a routine clinical procedure. However, whole-body FDG-PET seems to be a promising method in staging and follow-up of lymphoma, because it offers the unique capability of visualising metabolic activity throughout the entire body. Long-term multicenter studies are necessary to confirm these promising initial data. In the future, wholebody FDG-PET will probably be the technique of choice for immunoscintigraphic studies with radiolabeled monoclonal antibodies and studies on the pharmacokinetics of cytostatic compounds.