Computed tomography, magnetic resonance and gallium 67 scintigraphy for the imaging of residual lymphoma

The introduction of computed tomography (CT) has greatly improved lymphoma staging procedures and is presently the most common and most important radiologic technique employed for this purpose and for evaluating the response to treatment. However, since CT only gives an anatomic measure of the tumor, in some cases (particularly those with bulky mediastinal involvement), it is not useful in distinguishing between non-tumor images like fibrotic scars and residual neoplastic tissue following treatment. In such cases it may be difficult to reach a conclusion about the state of remission and to make an appropriate decision regarding subsequent treatment. Magnetic resonance (MR), with T1 and T2 sequences, and gallium 67 (67 Ga) scintigraphy (planar and SPECT) may help to elaborate a functional image that permits more careful appreciation of the nature of post therapeutic residual tissue.1-5 Furthermore, 67 Ga planar total body scintigraphy can detect lymphomatous involvement in sites that usually cannot be explored by thoracic and abdominal CT, which is currently used for staging purposes. We report here the images from two patients affected by Hodgkin’s disease (HD), obtained by CT, MR and 67 Ga planar and SPECT scintigraphy.