The purpose of this study was to determine the reliability of the splenic index (SI) in children with Hodgkin's disease (HD). Seventeen patients who underwent staging laparotomy for HD were included in this study. Pretreatment computed tomography scans of these patients were reviewed retrospectively to determine the SI. The specificity, sensitivity, positive and negative predictive values, and accuracy of the SI were calculated. The sensitivity and specificity of the SI were 50% and 66%, respectively. The SI alone accurately identified or ruled out involvement with HD in 10 of 17 patients. Positive and negative predictive values of the SI were 57% and 60%, respectively. Even with the use of the SI, computed tomography alone remains unreliable to determine splenic involvement in children with HD. Additional imaging studies, especially fluorodeoxyglucose positron emission tomography, may improve the clinical staging of HD.
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