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(Radiology. 1999;210:487-491.)
© RSNA, 1999

Nuclear Medicine

Hodgkin Disease: Prediction of Outcome with 67Ga Scintigraphy after One Cycle of Chemotherapy

Dov Front, MD, PhD1, Rachel Bar-Shalom, MD1, Maya Mor, MD1, Nissim Haim, MD2, Ron Epelbaum, MD2, Alex Frenkel, DSc1, Diana Gaitini, MD3, Gerald M. Kolodny, MD1 and Ora Israel, MD1

1 Departments of Nuclear Medicine (D.F., R.B.S., M.M., A.F., G.M.K., O.I.)
2 Oncology (N.H., R.E.)
3 Radiology (D.G.), Rambam Medical Center and the Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 35254, Israel.

PURPOSE: To investigate gallium 67 scintigraphy performed early during treatment as a means to predict outcome and thus to optimize treatment of Hodgkin disease (HD) in the future.

MATERIALS AND METHODS: Ninety-eight patients with HD were examined. Thirty-one patients underwent 67Ga scintigraphy after one chemotherapy cycle and 83 patients after a mean 3.5 cycles (range, 2–5 cycles). Sixteen patients underwent 67Ga scintigraphy both after one cycle and at midtreatment. Patients underwent whole-body scintigraphy and single photon emission computed tomography of the torso. Torso computed tomography (CT) was performed after a mean 3.5 cycles (range, 2–6 cycles). Failure-free survival was compared between patients with positive and patients with negative test findings (Kaplan-Meier method), and the significance of the difference was calculated. The association of failure-free survival with various prognostic clinical factors before treatment was compared (log-rank test univariate analysis).

RESULTS: Failure-free survival differed significantly (P < .002) between patients with positive and patients with negative 67Ga scintigrams after one chemotherapy cycle but not at midtreatment. Failure-free survival was not significantly different between patients with positive and patients with negative CT scans at midtreatment. Twenty-two (92%) of 24 patients with negative 67Ga scintigrams after one cycle and 64 (82%) of 78 patients with negative scintigrams at midtreatment remained in complete response. In four (57%) of seven patients with positive 67Ga scintigrams after one cycle, treatment failed.

CONCLUSION: 67Ga scintigraphy after one cycle of chemotherapy is a good early predictor of outcome of HD.

Index terms: Emission CT (ECT), 99.12962, 99.8342 • Gallium, radioactive, 99.12962, 99.12966, 99.12974, 99.8342 • Hodgkin disease, 99.8342 • Lymphatic system, neoplasms, 99.8342 • Lymphoma, radionuclide studies, 99.12966, 99.12974, 99.8342




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