Computed tomography and positron emission tomography/computed tomography surveillance after combined modality treatment of supradiaphragmatic Hodgkin lymphoma: a clinical and economic perspective

Leuk Lymphoma. 2013 Oct;54(10):2168-76. doi: 10.3109/10428194.2013.767902. Epub 2013 Feb 12.

Abstract

We studied the clinical benefits of radiological imaging, in the follow-up of patients after combined modality treatment for stage I/II classical supradiaphragmatic Hodgkin lymphoma (HL). Imaging data were collected for 78 adults treated during 1996-2008. Median follow-up was 4.6 years. Six of the nine relapses were detected clinically. On average, 31 imaging studies/patient were performed, with an estimated cost of $12 608/patient. Chest computed tomography (CT) scans accounted for 25%, abdominopelvic CT scans 41% and positron emission tomography (PET) or PET/CT scans 22% of this expense. Only one patient recurred infradiaphragmatically. The estimated radiation dose from imaging was 399 mSv and 229 mSv per patient, in relapse and non-relapse groups, respectively. CT scans contributed over 80% of the imaging radiation exposure. The routine use of CT scans in the surveillance of patients with HL after curative treatment adds to healthcare costs and total body radiation exposure with a low yield. History and physical examination remain effective tools for the follow-up of patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Hodgkin Disease / diagnosis*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Positron-Emission Tomography* / economics
  • Recurrence
  • Tomography, X-Ray Computed* / economics
  • Treatment Outcome
  • Young Adult