Diagnostic accuracy of ultrasound and computed tomography in the staging of Hodgkin's disease. Verification by laparotomy in 100 cases
✍ Scribed by Reinhold Munker; Angelika Stengel; Axel Stäbler; Erhard Hiller; Gerd Brehm
- Publisher
- John Wiley and Sons
- Year
- 1995
- Tongue
- English
- Weight
- 647 KB
- Volume
- 76
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
Background. A staging laparotomy still is considered the gold standard to detect occult abdominal involvement in Hodgkin's disease. Computed tomography and ultrasound are routinely available for diagnostic imaging. To the authors' knowledge, the exact contribution of ultrasound for the staging of Hodgkin's disease has not been reported in a large series of patients before this study.
Methods. The diagnostic accuracy of abdominal ultrasound was compared with that of computed tomography and laparotomy in 100 patients with biopsy-proven Hodgkin's disease. Liver, spleen, paraaortic, and iliac lymph nodes were evaluated separately.
Results. Seventeen patients bad a higher disease stage after surgery (17%). Considering only patients without known abdominal disease (supradiaphragmatic involvement), 14/79 (18%) had a positive staging laparotomy. Ultrasound had superior sensitivity for detecting splenic involvement with Hodgkin's disease (sensitivity, 63% compared with 37% for computed tomography). The specificity of both methods for detecting splenic disease was identical (99% vs. 96%). Inhomogeneities of structure or small nodular infiltrates were detected preferentially by ultrasound. Hepatic involvement also was visualized better by ultrasound than by computed tomography. Lymph nodes at the splenic hilus were recognized by both methods with identical sensitivity (64% vs. 62%). Paraaortic and iliac lymph nodes were recognized with greater sensitivity by computed tomography than by ul-From the *Medizimsche Klinik 111 und tInstitut fur Radiologische Diagnostik der Ludwigs-Maximilians-