Pretherapy Gallium-67 scanning in paediatric patients with Hodgkin's disease

Abstract

Objective: To investigate the correlation between gallium-67 (67Ga) uptake and histological subtypes of Hodgkin's disease (HD) in paediatric patients.

Subjects and methods: Fifty-eight patients (45 males and 13 females aged 9.2 +/- 4 years, range 1.5-17 years) with histologically diagnosed HD underwent pretherapy 67Ga scanning on days 2, 5, 12 or 14 days after intravenous administration of 25-50 MBq (0.7-1.4 mCi) of 67Ga citrate. The scans were evaluated both visually and quantitatively using the activity of 67Ga in the liver as a reference. Clinical outcome of 11 patients with high diffuse 67Ga skeletal uptake was compared with that of 17 patients showing normal distribution of 67Ga in the skeleton.

Results: Of the 58 patients, the 67Ga scans were positive in 47 patients with 117 lesions. Visual analysis did not differentiate between the histological variants of HD. However, quantitative analysis of lesion-to-liver ratios showed significantly higher values of 67Ga uptake in the mixed cellularity type than in the nodular sclerosis type (t = -3.7, p < 0.001). Patients with high skeletal uptake had a higher relapse rate (6/11) than those with normal skeletal uptake (3/17).

Conclusion: The findings show that quantitative analysis of 67Ga uptake can differentiate between the two main subtypes of HD (mixed cellularity and nodular sclerosis). Further diffuse skeletal uptake of 67Ga indicates a higher relapse rate.