Gallium‐67 citrate scanning in Hodgkin's disease and non‐Hodgkin's lymphoma

Gallium‐67 citrate scintigraphy was performed in 33 patients with Hodgkin's disease and 25 patients with non‐Hodgkin's lymphoma. Three hundred twenty‐eight sites of potential involvement were investigated. Confirmation of involvement was made by physical examination, roentgenographic evaluation and histopathologic examination of tissue obtained at diagnostic laparotomy. The results of scintigraphy correlated with all other clinicopathologic data in only 35% of patients, the true‐positive rate being significantly higher above the diaphragm (61%) than below (40%). The overall true‐positive and true‐negative rates were 53 and 90%, respectively. A significant correlation existed between tumor histology and scanning accuracy; the true‐positive rate in Hodgkin's disease was 74% compared to only 13% in patients with lymphocytic lymphoma. A similar variation of 67Ga concentration with tumor histology was also noted in 70 tissue specimens obtained from 28 patients at the time of diagnostic laparotomy or biopsy. The routine use of 67Ga‐citrate to detect splenic involvement with tumor appeared to be precluded by the low true‐positive and high false‐negative rates of 57 and 27%, respectively. Gallium‐67‐citrate scintigraphy may be useful as an adjunct to established clinical staging procedures in untreated patients and in the detection of recurrent disease in treated patients. Our data indicate it is not sufficiently reliable to replace established methods presently used for clinical staging.