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CT scan or MRI-- which is better to evaluate lymphoma?
Mar 13, 2002

Dear Dr. Dezube, I would like to know which one of the 2 procedures (CT scan or MRI), is better in evaluating, measuring and staging from the pathological point of view, lymph nodes in the abdominal area, giving the fact that CT poses a higher risk due to the high ionizing radiation? What other risks does a MRI scan carry (except for the metal or heart implants) ? Also, is it possible for a lymph node to be in a normal size, and still harbour cancer cells (in a NHL situation)? Thank you in advance,

Response from Dr. Dezube

The best way, in my opinion, to stage lymphoma is with a combination of two different scans-- CT scan and gallium scan. The CT scan, which should be performed with the use of a dye, pretty much accurately identifies abnormal lymph nodes. The gallium scan, which is performed by injecting a radioactively material which accumulates in lymph nodes harbouring lymphoma cells, tells one which of the abnormal lymph nodes on the CT scan actually harbour tumors. Virtually all of my patients, both lymphoma and Hodgkin's disease, will get both these tests. I use MRI scans very infrequently.

As just one example, I have a patient in which his CT scan showed abnormal lymph nodes in the chest, abdomen, and arm pits. The gallium scan only lit up in the chest and abdomen. This let me know that lymph nodes in the arm pits probably don't harbour any tumors.

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