Clinical usefulness of ⁶⁷gallium scanning in the malignant lymphomas

To determine the clinical usefulness of ⁶⁷gallium (Ga) scanning in the evaluation of patients with lymphomas, we reviewed 142 total body Ga scans performed on 44 patients with Hodgkin's disease and 53 patients with non-Hodgkin's lymphoma. Fifty-two per cent (123 of 236) of known disease sites were detected on scan. The false-positive rate was less than 5 per cent. The accuracy of detecting lymphoma varied in individual anatomic areas from 33 per cent in the axilla to 73 per cent in the thorax. In eight patients with bone involvement, all bone lesions were detected on scan. The size of the lesion appeared to influence accuracy, since tumors greater than 3 cm in diameter were more often positive. There was no significant difference in scan accuracy between patients with Hodgkin's disease and non-Hodgkin's lymphomas, regardless of prior therapy or major histologic subclassification. Twenty-four patients had lymphangiography and a Ga scan prior to staging laparotomy. As confirmed by the surgery, all abdominal nodal disease visualized by lymphangiogram was also positive on Ga scan. However, there were two false-positive lymphangiograms compared to no false-positive Ga scans. We conclude that total body Ga scanning is a reliable and non-invasive method of detecting lymphoma, particularly in the thorax and bone. It appears to be equally useful in all histologic types as well as in previously treated patients.