Benefit of true whole body FDG PET/CT imaging in pediatric Hodgkin's lymphoma

1067 Learning Objectives In order to avoid excess radiation exposure, limited field of view (LFOV) versus true whole body (TWB) imaging is suggested in patients with lymphoma, especially in pediatric population. Here we evaluate the benefit of TWB FDG PET/CT in correctly identifying more accurate extent of pediatric Hodgkin’s lymphoma (HL). Methods: 10-year-old boy with bilateral cervical lymphadenopathy, mediastinal mass with lung involvement and probable splenic lesions on contrast enhanced CT imaging was evaluated with TWB FDG PET/CT as part of initial staging work up. Results: TWB FDG PET/CT scan demonstrated FDG avid bilateral cervical lymphadenopathy and mediastinal mass along with right lung invasion. It also showed definite involvement of spleen which was less apparent on contrast enhanced CT. In addition, TWB scan also demonstrate FDG avid lesions in left distal femur and heterogeneous marrow uptake that was suspicious for malignancy. Upon biopsy, the left distal femur was positive for HL. Chemotherapy was inititiated. Follow up TWB imaging demonstrated good metabolic treatment response. In this study, TWB scan was able to correctly identify lesions that would have been missed on LFOV imaging (from base of skull to proximal/mid thigh), hence helping in accurately assessing the extent of the disease. Furthermore, FDG PET/CT scan also strengthens the less obvious CT findings of splenic involvement. Conclusion: In comparison to LFOV imaging, TWB imaging helped in correctly identifying the accurate extent of the disease and improved the ability to monitor response to therapy