Hussein R Farghaly, Hatem A Nasr, Abdullah O Al-qarni, Wala H Elhussein.
18F-FDG PET/CT for first follow-up post chemotherapy in lymphoma: is it mandatory to do whole-body scan?.
Pak J Nuclear Med Jan ;5(1):28-36.

Aims To assess the feasibility of 18F-2-fluoro- 2-deoxy-D-glucose positron emission tomo graphy/computed tomography (FDG-PET/CT) scan, which is confined to the original sites of lymphoma in the first follow-up post chemotherapy (1st FU-P-chemotherapy) with an aim to reduce the patient's radiation exposure and the scan duration. Methods FDG PET/CT scans of 100 lymphoma patients were reviewed and the sites of disease in pre-chemotherapy (P-CHT) and the 1st FU-P-chemotherapy scans were recorded. The possible "saved time" from the PET part of the scan and a "reduction in radiation dose" from CT part, were calculated, when we used PET-CT scan limited to the original sites of lymphoma in 1st FU-P-chemotherapy scan. Results 45% of first P-CHT-PET-CT scans showed no significant residual-FDG-uptake indicating complete metabolic response. Significant residual-FDG-uptake at known disease sites was seen in 55% of first P-CHT PET-CT scans, indicating residual disease. There was no detected significant FDG uptake in any new site in the first P-chemo PET-CT, indicating no further unexpected sites of lymphoma. The scan time was reduced by 5.3±1.47 minutes and radiation dose reduced by 4.2±1.2 mSv, without missing any significant findings when first FU-P-chemo PET/CT scan limited to the sites of known disease was performed. Conclusion It is not mandatory to do a whole-body 18F-FDG PET/CT scan in assessment of early response to chemotherapy in curable lymphoma and it may be sufficient to limit scan to the sites of known disease without any loss of significant findings but resulting in a reduction of the total radiation dose and reducing the scan time.

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