Biopsy on the supraclavicular node: Hodgkin lymphoma, scleronodular. â No clinical symptoms; VES 21; LDH 664. ⢠PET/CT (29.5.07) : lesion in the left anterior ...
Nucl.Med.Department S.Croce e Carle Hospital Cuneo –Italy
Clinical case • ♂; 20 aa • Presence of node in the left supraclavicular area at the end of april 2007 • In may 2007 the pt performed – – – –
eco: left supraclavicular ipoecogenic node CT: bulky lesion in the anterior left mediastinum (6x12 cm) extended to the retroclavicular region Biopsy on the supraclavicular node: Hodgkin lymphoma, scleronodular No clinical symptoms; VES 21; LDH 664
• PET/CT
(29.5.07) : lesion in the left anterior mediastinum extended to the retroclavicular region
STAGE: IIA Planned therapy ABVD x 4 cycle + Rxtherapy of the bulky disease
Baseline PET/CT
Interim PET/CT after 2 ABVD residual node in the anterior mediastinum
Baseline
Interim
Baseline
Score 4 SUVMax • lesion 4.9 • Liver 3.1
Score 4 SUVMax • lesion 5.5 • Liver 3.6
Interim
Interim
End of therapy CR
Interim
Score 4 SUVMax • lesion 5.5 • Liver 3.6
Score 2 SUVMax • lesion 2.8 • Liver 4.2
End of therapy
End of therapy PET/CT 12.3.2008
Follow up • PET/CT 28.10.08 neg • PET/CT 23.9.2009 neg • 13.4.2011 CR Considerations: according to both qualitative (score) and semiquantitative (SUV) analysis the patient had residual disease in the interim PET but the Patient is still in CR after 4 years.
How can we improve the specificity of both qualitative and semiquantitative interpretation?
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