Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Radio-diagnosis

The aim of this work was to evaluate the role the PET/CT in initial diagnosis and staging of lymphoma, assessment of response to radio or chemotherapy therapy, follow up and assessment of remissions and relapses in patients with lymphoma, detection of recurrence, Highlighting the advantages obtained by using the two modalities together through a combined PET/CT in-line system than the advantage gained by using each modality alone. In particular, a five-point scale (Deauville criteria) to grade response using PET-CT, which can be adapted to suit requirements for early- and late- therapeutic response assessment. Results: Lymphoma is the most common primary hematopoietic malignancy. The extra nodal involvements in NHL are compromising in approximately 40% of patients. PET/CT mostly upstaged disease when compared with CT alone. The overall comparison between CECT and PET/CT in groups of our study showed significant sensitivity of PET/CT in LN, splenic, bone marrow and other extranodal affection and it showed relative moderate specificity in other extranodal detection. Lymph nodes detection on PET-CT images showed high sensitivity of 100% with low specificity (25%) and significant P value 0.0001 and fair agreement (Kappa 0.222). PET CT also had sensitivity of about 90.9% and specificity of about 82.1% in detection of splenic involvement in NHL and significant P value 0.001 and substantial agreement (Kappa 0.610). It had high sensitivity (100%) and specificity (74.5%) for the evaluation of extra nodal involvement than contrast enhanced CT and fair agreement (Kappa 0.610)

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