Value of combined 67Ga and 99Tc(m)-human immunoglobulin G whole-body scanning in malignant lymphoma

Human immunoglobulin G labelled with 99Tc(m) (99Tc(m)-HIG) is an agent introduced for the localization of inflammatory lesions. There is also a limited number of reports concerning the uptake of this agent by malignant lesions. The aim of this study was to evaluate the uptake of 99Tc(m)-HIG by lymphoma. Twenty-three patients (five female, 18 male) with known Hodgkin's or non-Hodgkin's lymphoma for a period of 2-6 years (mean 4.2 years) and which, by using computed tomography (CT), showed recurrence, were included in the study. The patients were aged between 32 and 68 years (mean 38 +/- 5 years). No evidence of inflammation or infection was seen in any of these patients. CT, 99Tc(m)-HIG and a 67Ga scan were performed in the same week. CT showed abdominal involvement in 17 patients, pelvic involvement in 11, and thorax involvement in 11. 99Tc(m)-HIG showed higher sensitivity (94.1%) in the abdomen, a similar sensitivity (63.6%) in thorax, but lower (18.1%) in pelvic area than for 67Ga. 99Tc(m)-HIG was found to be more useful for the evaluation of abdominal involvement compared to 67Ga due to gastrointestinal excretion of the latter. The resolution of 67Ga was better than 99Tc(m)-HIG in thorax and pelvis. Using 99Tc(m)-HIG and 67Ga together in lymphoma may increase sensitivity.