Pretherapy Gallium-67 Scanning in Paediatric Patients with Hodgkin’s Disease

Abstract

Objective: To investigate the correlation between gallium-67 (⁶⁷Ga) uptake and histological subtypes of Hodgkin’s disease (HD) in paediatric patients. Subjects and Methods: Fifty-eight patients (45 males and 13 females aged 9.2 ± 4 years, range 1.5–17 years) with histologically diagnosed HD underwent pretherapy ⁶⁷Ga scanning on days 2, 5, 12 or 14 days after intravenous administration of 25–50 MBq (0.7–1.4 mCi) of ⁶⁷Ga citrate. The scans were evaluated both visually and quantitatively using the activity of ⁶⁷Ga in the liver as a reference. Clinical outcome of 11 patients with high diffuse ⁶⁷Ga skeletal uptake was compared with that of 17 patients showing normal distribution of ⁶⁷Ga in the skeleton. Results: Of the 58 patients, the ⁶⁷Ga scans were positive in 47 patients with 117 lesions. Visual analysis did not differentiate between the histological variants of HD. However, quantitative analysis of lesion-to-liver ratios showed significantly higher values of ⁶⁷Ga uptake in the mixed cellularity type than in the nodular sclerosis type (t = –3.7, p < 0.001). Patients with high skeletal uptake had a higher relapse rate (6/11) than those with normal skeletal uptake (3/17). Conclusion: The findings show that quantitative analysis of ⁶⁷Ga uptake can differentiate between the two main subtypes of HD (mixed cellularity and nodular sclerosis). Further diffuse skeletal uptake of ⁶⁷Ga indicates a higher relapse rate.