Ga-67 imaging in Hodgkin's disease.

In order to answer the question if Ga-67 imaging has a practical utility for the management of the patient with Hodgkin's disease, 108 scans performed on 60 patients were reviewed. When used during the initial staging of the disease or during restaging because of recurrences, Ga-67 imaging-at least in our experience-gave many false negative results in the cervical, axillary and inguinal areas, whereas the majority of true positive scans was found at the mediastinal level (including the lower mediastinum), and also in the lung parenchyma and the upper epigastric regions. Because of its lack of sensitivity, Ga-67 imaging cannot replace other staging procedures, but nevertheless is a valuable adjunctive test, as it can identify tumor localization that may have remained undetected by other methods. Fifty-four scans were performed to monitor treatment with radiation therapy or chemotherapeutic agents. Disappearance or decreases of Ga-67 uptake after treatment usually corresponded to a disappearance or regression of the tumor as ascertained by other methods. When the treatment was shown to be ineffective, Ga-67 uptake persisted or even became more prominent. When during follow-up, a new concentration of Ga-67 appeared at the original location or elsewhere, a relapse was extremely likely. However, one must be aware of false positive images. In our material, no correlation was found between the intensity of the Ga-67 uptake and the histological subtypes of Hodgkin's disease. Neither did we observe any relation to the blood sedimentation rate or serum iron levels.