What alternatives may be used to accurately stage Hodgkin lymphoma if PET-CT is not available?

FAQ published on March 3, 2016
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Bruce D. Cheson, MD
Professor of Medicine
Director of Hematology Research
Georgetown University Hospital
Lombardi Comprehensive Cancer Center
Washington, DC
What alternatives may be used to accurately stage Hodgkin lymphoma if PET-CT is not available?
Welcome to Managing Hodgkin Lymphoma. My name is Bruce Cheson and I am deputy chief of hematology/oncology and head of hematology at Georgetown University Hospital, the Lombardi Comprehensive Cancer Center. I am frequently asked, “What alternatives may be used to accurately stage Hodgkin lymphoma if PET-CT is not available?” Well the history of staging Hodgkin lymphoma actually goes back many decades and it was very, very complicated in those days. In fact, the first person we called to help us stage the patient was a surgeon. We did staging laparotomies on patients; they were opened up, the spleen was taken out, the liver was biopsied, nodes were sampled. Fortunately, the CAT scan came along which obviated the need for doing that sort of macabre procedure on our patients. We were able to accurately stage Hodgkin lymphoma for a long time just with the use of CT scans. And now we have PET scans, and not everybody has PET scans available to them at their local institution. It is great, they are very accurate, they are more accurate than CT scans, they are more sensitive and more specific; however, you can do a very good job of staging patients without having a PET scan available. But one other feature of the PET-CT scan is that it eliminates the need to perform the dreaded bone marrow biopsy on the majority of patients with Hodgkin lymphoma for staging purposes. So if you do not have PET scan, you can do it with a CAT scan. And it was not until actually 2014, with the new Lugano classification, that we published which PET scans were actually formally included as part of the staging of Hodgkin lymphoma. So thank you for viewing this activity. For additional resources, please view the other educational activities on ManagingHodgkinLymphoma.com.
Last modified: March 2, 2016
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