Current Role of Functional Imaging in the Management of Lymphoma

Cheson, Bruce D.; Meignan, Michel

doi:10.1007/s11912-021-01127-6

Cited by 16 publications

(16 citation statements)

References 84 publications

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“…In the staging of FDG-avid subtypes, FDG-PET/CT is the preferred modality for staging than CT, especially for identifying extranodal sites [ 10 ]. FDG-PET/CT removes the need for BMB in most patients of DLBCL and HL, and it allows for mapping of initial disease sites for accurate response assessment [ 17 ]. For patients with PTCL, FDG-PET/ CT identifies more disease sites and usually upstages diagnosis compared with CT, but PET-induced stage alteration rarely changes treatment strategies because most affected patients have advanced disease [ 18 ].…”

Section: Current Role Of Fdg-pet/ct In the Management Of Lymphoma And...mentioning

confidence: 99%

Staging and response assessment of lymphoma: a brief review of the Lugano classification and the role of FDG-PET/CT

Yoo

2022

Blood Res

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The accurate assessment of initial disease status and therapeutic responses is critical to the optimal management of patients with lymphoma. Currently, staging and treatment response evaluation for lymphoma has been standardized into the Lugano classification. Lugano classification incorporates positron emission tomography (PET) into the existing response criteria, and response assessment using FDG-PET/CT has been proven to predict the prognosis in various lymphoma subtypes effectively. We will briefly review the current staging and response evaluation system and explore the role of functional imaging in the field of lymphoma.

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Section: Current Role Of Fdg-pet/ct In the Management Of Lymphoma And...mentioning

confidence: 99%

Staging and response assessment of lymphoma: a brief review of the Lugano classification and the role of FDG-PET/CT

Yoo

2022

Blood Res

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“…The Lugano conference established FDG PET-CT as a critical modality in guiding management of all FDG-avid lymphomas, which includes HL and DLBCL, except for lymphomas that are typically low in metabolic activity, such as small lymphocytic lymphoma, marginal zone lymphoma and some cutaneous lymphomas [ 8 , 28 ]. A baseline FDG PET-CT should be performed before initiation of any treatment, as any therapeutic intervention may rapidly alter tumor metabolism, even within only a few days, thus affecting scan sensitivity ( Figure 1 ) [ 28 ]. In both HL and DLBCL, inclusion of the prognostic index of total metabolic tumor (TMTV) has been shown to lead to a change in patient management and treatment [ 29 ].…”

Section: Hematologic Malignanciesmentioning

confidence: 99%

“…In both HL and DLBCL, inclusion of the prognostic index of total metabolic tumor (TMTV) has been shown to lead to a change in patient management and treatment [ 29 ]. TMTV has been reported to better define risk than the Ann Arbor Staging [ 28 ]. However, the use of TMTV as defined by FDG PET-CT has not yet been widely adopted in clinical practice.…”

Section: Hematologic Malignanciesmentioning

confidence: 99%

“…FDG PET-CT is more accurate than CT in staging of aggressive lymphomas, showing increased sensitivity and specifically for detecting extra-nodal sites of disease. Compared to CT, it is reported that FDG PET-CT upstages 10–30% of patients with lymphoma, primarily in the detection of additional sites of disease [ 28 ]. It is also critical in excluding additional sites in patients thought to have limited disease who may be eligible for management by radiation therapy alone.…”

Section: Hematologic Malignanciesmentioning

confidence: 99%

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PET-CT in Clinical Adult Oncology: I. Hematologic Malignancies

Salem

Shah

Covington

et al. 2022

Cancers

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PET-CT is an advanced imaging modality with many oncologic applications, including staging, assessment of response to therapy, restaging and evaluation of suspected recurrence. The goal of this 6-part series of review articles is to provide practical information to providers and imaging professionals regarding the best use of PET-CT for the more common adult malignancies. In the first article of this series, hematologic malignancies are addressed. The classification of these malignancies will be outlined, with the disclaimer that the classification of lymphomas is constantly evolving. Critical applications, potential pitfalls, and nuances of PET-CT imaging in hematologic malignancies and imaging features of the major categories of these tumors are addressed. Issues of clinical importance that must be reported by the imaging professionals are outlined. The focus of this article is on [18F] fluorodeoxyglucose (FDG), rather that research tracers or those requiring a local cyclotron. This information will serve as a resource for the appropriate role and limitations of PET-CT in the clinical management of patients with hematological malignancy for health care professionals caring for adult patients with hematologic malignancies. It also serves as a practical guide for imaging providers, including radiologists, nuclear medicine physicians and their trainees.

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“…This marked PPV variability is probably related to post-therapy inflammatory changes that could affect the interpretation of residual uptake, resulting in an interobserver evaluation variability in scoring DS 3 and 4 [ 12 , 13 ]. Nowadays, in case of persistent doubtful positive sites, a biopsy is performed in routine practice [ 14 ]. These findings suggested the need to search for new criteria to overcome the aforementioned DS limitations in NHL.…”

Section: Introductionmentioning

confidence: 99%

Lesion-to-Liver SUVmax Ratio to Improve the Prognostic Value of the End of Treatment PET/CT in Diffuse Large B-Cell Lymphoma

Ferrari

Pisani

Masi

et al. 2022

JCM

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Background: Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma worldwide. After first-line therapy, 30–40% of patients relapse or experiment with refractory disease. 18F-FDG PET/CT represents a validated diagnostic tool in post-treatment evaluation of FDG-avid lymphoma, and the Deauville Score (DS), a five-point visual scale, is usually used to assess response. However, the increased number of false positive findings suggested the need to search for new parameters. The aim of this study is to evaluate the prognostic value of End-of-Treatment-PET, comparing DS to the semi-quantitative Lesion-to-Liver ratio (LLR). Methods: newly diagnosed DLBCL patients who underwent 18F-FDG PET/CT were retrospectively analyzed. End-of-Treatment PET findings were assessed first using DS; secondly, assigned the LLR. Results: a total of 105 patients were finally enrolled. ROC analysis showed an LLR of 1.80 as the optimal cutoff value for predicting a disease progression (sensitivity 58%, specificity 95%). Both DS and LLR showed a statistically significant correlation with PFS and OS. LLR resulted in a better diagnostic performance than DS. Conclusions: LLR showed to be a reliable diagnostic method to assess treatment response in DLBCL. The integration of visual and semi-quantitative criteria could help in decision making, improving specificity and PPV.

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Current Role of Functional Imaging in the Management of Lymphoma

Cited by 16 publications

References 84 publications

Staging and response assessment of lymphoma: a brief review of the Lugano classification and the role of FDG-PET/CT

Staging and response assessment of lymphoma: a brief review of the Lugano classification and the role of FDG-PET/CT

PET-CT in Clinical Adult Oncology: I. Hematologic Malignancies

Lesion-to-Liver SUVmax Ratio to Improve the Prognostic Value of the End of Treatment PET/CT in Diffuse Large B-Cell Lymphoma

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