Imaging for Staging and Response Assessment in Lymphoma

Abstract

Lymphoma comprises a heterogeneous group of diseases; remarkable advances have been made in diagnosis and treatment. Diagnostic imaging provides important information for staging and response assessment in patients with lymphoma. Over the years, staging systems have been refined, and dedicated criteria have been developed for evaluating response to therapy with both computed tomography (CT) and fluorine-18 fluorodeoxyglucose positron emission tomography (PET)/CT. The most recent system proposed for staging and response assessment, known as the Lugano classification, applies to both Hodgkin and non-Hodgkin lymphoma. The use of standardized criteria for staging and response assessment is important for making accurate treatment decisions and for determining the direction of further research. This review provides an overview of the updated CT and PET response criteria to familiarize the radiologist with the most important and clinically relevant aspects of lymphoma imaging. It also provides a short clinical update on lymphoma and the associated spectrum of imaging findings.

Clinical Indications and Impact on Management: Fourth and Subsequent Posttherapy Follow-up 18F-FDG PET/CT Scans in Oncology Patients

“…The role of 18 F-FDG PET/CT imaging in initial staging, therapy planning, and therapy assessment of different cancers has been well established (14)(15)(16)(17)(18)(19)(20). Multiple studies claimed that follow-up 18 F-FDG PET/CT scanning is valuable when there is a clinical suspicion of disease recurrence.…”

The value of fourth and subsequent post-treatment 18F-FDG PET/CT scans in the management of patients with non-Hodgkin’s lymphoma

“…We also classified indeterminate scan results as negative results in the study and this may lead to FN results. The histology, biology, and treatment goals are different among different NHL subtypes [23] and lead to heterogeneity in NHL patients. Although this may reduce the impact of the findings, it would require a considerably larger sample size to establish the impact of fourth and subsequent follow-up scans stratified by histological subtypes of NHL.…”

A Patient with a Right Atrium Mass and Congenital Heart Disease: A Challenging Diagnosis of a Stubborn Disease

“…(18)F-FDG PET/CT scanning is superior in this regard and, due to its noninvasive approach, should therefore be the diagnostic tool of choice for cardiac mass assessment for the elderly, particularly those who might lose the chance to receive invasive procedures such as TEE or myocardial biopsy. The sensitivity of FDG PET/CT imaging was reported to be 71–100%, with a specificity of 69–100% and a negative predictive value of 80–100% [8, 9]. …”