71 Lymphoma 3

Clinical Presentation

Approximately 15 months after receiving an autologous bone marrow transplant, a 43-year-old man with a history of Hodgkin lymphoma feels well and, in particular, does not have any respiratory distress. A re-staging examination is performed three months (Fig. 71.2) following the last follow-up (Fig. 71.1).

Fig. 71.1

Fig. 71.2

Fig. 71.3

Technique

• The patient is instructed to avoid vigorous exercise for 24 hours prior to the scan, fast for at least 4 hours before the study, drink water during the fasting and uptake periods, and void prior to the scan

• A venous serum glucose sample is obtained prior to the injection of ¹⁸F-FDG (reference range is < 120 mg/dl for non-diabetic patients and < 200 mg/dl for diabetic patients), and the patient’s height and weight are recorded

• A 10–20 mCi dose of ¹⁸F-FDG is injected intravenously (in a dimly lit quiet room for brain PET scans), and the patient is asked to rest comfortably in a room that is kept warm

• Most PET scans are now acquired on a hybrid PET/CT scanner, and a low dose spiral CT is acquired for attenuation correction of the PET images and for anatomic localization. Some centers may choose to perform oral and/or intravenous contrast-enhanced diagnostic CT as part of the PET/CT examination

• Sixty minutes following the ¹⁸

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