Positron emission tomography in the detection and staging of ocular adnexal lymphoproliferative disease.

Purpose: To evaluate the role of fluorine 18 deoxyglucose positron emission tomography (FDG PET) in the initial staging of ocular adnexal lymphoma (OAL).

Design: Retrospective nonrandomized case series.

Participants: Eleven patients with OAL who underwent FDG PET at initial staging.

Methods: Retrospective review of all the clinical and imaging records, including computed tomography (CT) and FDG PET.

Main Outcome Measures: The ability of PET studies to detect OAL and distant disease was compared with CT.

Results: Eleven patients with OAL who underwent FDG PET at initial staging were retrospectively reviewed having full access to their clinical and imaging data. Fluorine 18 deoxyglucose PET found distant disease in 5 of 6 lymphoma patients with systemic disease; 4 of these patients (66%) were upstaged, changing the clinical management. Orbital lesions were demonstrated in 3 of 11 patients, giving PET a sensitivity of 27% in the orbit and 83% systemically for detection of lymphoma.

Conclusion: The ability of FDG PET to find systemic extranodal lymphomatous sites not detected with conventional imaging provides valuable information in OAL patients, which may result in important changes in staging and management. The technique does have limitations in detecting OAL compared with conventional imaging, possibly owing to background physiologic activity in the extraocular muscles in the orbit and the small volume of some orbital deposits.