Muhammad Israr Ahmed, Muhammad Saad Ahmed, Waseem Mehmood Nizamani, Amna Rasul.
Beyond PET/CT in lymphoma: does PET/CT has similar diagnostic accuracy in recurrent lymphoma cases in TB - endemic countries.
Pak J Radiol Jun ;28(1):17-23.

TITLE:� Beyond PET/CT in lymphoma: Does PET/CT has similar diagnostic accuracy in recurrent lymphoma cases in TB-endemic countries. BACKGROUND:� Lymphoma includes histologically heterogeneous group of tumors which are derived from the cells of the immune system. OBJECTIVE:� The objective of this study is to determine the diagnostic accuracy of PET/CT in recurrence of lymphoma in treated cases. The PET CT findings were correlated with biopsy and histopathological diagnosis. METHODS:� After ethical committee approval, this study was conducted in the PET/CT suite, Department of Radiology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. The study design was cross sectional and sampling technique was non-probability and purposive. The sample size was 155 (Sample size estimated using 95% confidence level and 8% margin of error with an expected sensitivity value of PET/CT as 85% and specificity value as 95%). Patients of all age and both genders who had PET/CT avid disease on follow up scan after achieving complete response after first line of treatment. The patients who had a positive PET/CT were later discussed in MDT and were referred for biopsy. The biopsy of the patient was then performed in appropriate modality to document the exact histopathology which was gold standard in our study RESULTS: Histopathology confirmed that a total of 70 patients recurrent disease of lymphoma patients. �PET/CT correctly identified 64/70 of the recurrent cases of lymphoma. Thus the sensitivity of the PET/CT was 91.4%. On the other hand, PET/CT truly identified 37/85 cases without recurrent disease of lymphoma making the specificity as 43.5%. The Overall diagnostic accuracy of the PET/CT was 65.5%. Positive and negative predicative values for a diagnosis of recurrent disease of lymphoma on PET/CT were 57.7% and 86.0% respectively. � CONCLUSION: We have found 65% diagnostic accuracy of PET/CT for detecting recurrent disease in the Lymphoma patients which is lower than internationally published data i.e. 85%. Possible cause of this would be high burden of infectious diseases (particularly tuberculosis) in our society. �

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