| Objective The aim of the study was to evaluate the role of 99Tcm-octreotide in the initial staging and restage of malignant lymphoma.Materials and Methods Overall, 30 patients with clinically highly suspected or known lymphomas(24 cases), recurrent (2 cases) and post-treatment lymphomas(4 patients), including 6 Hodgkin's Diseases (HD), 22 non-Hodgkin lymphomas(NHL) and 2 inflammatory reactive proliferations who were proven by histology and/or immunohistochemistry, were studied with ultrasound, CT and 99Tcm-octreotide scintigraphy. 67Ga scintigraphy were performed in 5 Out of 28 patients with lymphoma(1 untreated lymphoma, 2 recurrent lymphomas and 2 post-treatment lymphomas) and bone marrow aspiration were done in 8 untreated lymphomas. ADAC Vertex SPECT (24 persons) and Infinia VC Hawkeye SPECT/CT(6 patients) with double large-field-of-view gamma cameras and equipped with two low energy high resolution collimators was used. Patients had been fasting for at least 12 hours, and were injected intravenously 555～740MBq 99Tcm-octreotide. Three to four hours later, serial whole body scan, and/or spot views, single-photon emission tomography (30～40 sec per frame) of neck/thorax and abdomen/pelvis were performed. Images were assessed visually. Accumulation of radioactivity at sites other than physiologic uptake is considered to be abnormal and indicates the presence of pathologic positive tissue. In organs with physiologic uptake of 99Tcm-octreotide (e.g. liver and spleen), inhomogeneous or focal uptake patterns were considered to be indicative of lymphoma. 99Tcm-octreotide findings were compared with the results of CT , ultrasound , 67Ga scan and bone marrow aspiration. All 28 patients with lymphoma were investigated for verification of staging established by other modalities.Results There were the positive results of 99Tcm-octreotide scan in 22 of 30 patients, including 2 cases with inflammatory reactive proliferations. The patients with lymphoma related sensitivity was 83.3%(20/24). The false negative rate was 16.7%(4/24). The lesions related sensitivity was 49.3%(72/146) in all lesions, 51.6%(48/93) in supradiaphragmatic lesions, 45.3%(24/53) in infradiaphragmatic lesions, respectively. The specificity of 99Tcm-octreotide scan was 66.7%(4/6) in patients and 99.6% in organs and lymph nodes lesion regions. 53 of 72 positive lesions were revealed in peripheral malignant lymphoma lesions. Four false positive lesions were detected. The sensitivity of conventional imaging procedures, 99Tcm-octreotide SPECT, whole body scan and planar views were 97.3%, 49.3%, 32.2% and 32.2%(p<0.05), respectively. In comparison with the results of CT , ultrasound and 67Ga scan, 99Tcm-octreotide scan are inferior for visualization of malignant lymphoma lesions in thorax and abdomen/pelvis.
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