Positron emission tomography/computed tomography in the management of Hodgkin and B-cell non-Hodgkin lymphoma: An update

Malik E. Juweid*, Marguerite Mueller, Abdullah Alhouri, M. Ziad A-Risheq, Felix M. Mottaghy

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

F-18-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is now an integral part of lymphoma staging and management. Because of its greater accuracy compared with CT alone, PET/CT is currently routinely performed for staging and for response assessment at the end of treatment in the vast majority of FDG-avid lymphomas and is the cornerstone of response classification for these lymphomas according to the Lugano classification. Interim PET/CT, typically performed after 2 to 4 of 6 to 8 chemotherapy/chemoimmunotherapy cycles with or without radiation, is commonly performed for prognostication and potential treatment escalation or de-escalation early in the course of therapy, a concept known as response-adapted or risk-adapted treatment. Quantitative PET is an area of growing interest. Metrics, such as the standardized uptake value, changes (Delta) in the standardized uptake value, metabolic tumor volume, and total lesion glycolysis, are being investigated as more reproducible and potentially more accurate predictors of response and prognosis. Despite the progress made in standardizing the use of PET/CT in lymphoma, challenges remain, particularly with respect to its limited positive predictive value, emphasizing the need for more specific molecular probes. This review highlights the most relevant applications of PET/CT in Hodgkin and B-cell non-Hodgkin lymphoma, its strengths and limitations, as well as recent efforts at implementing PET/CT-based metrics as promising tools for precision medicine.

Original languageEnglish
Pages (from-to)3727-3741
Number of pages15
JournalCancer
Volume127
Issue number20
Early online date19 Jul 2021
DOIs
Publication statusPublished - 15 Oct 2021

Keywords

  • Deauville 5-point scale
  • diffuse large B-cell lymphoma
  • end-of-treatment positron emission tomography
  • computed tomography
  • follicular lymphoma
  • Hodgkin lymphoma
  • interim positron emission tomography
  • Lugano classification
  • non-Hodgkin lymphoma
  • positron emission tomography
  • computed tomography (PET
  • CT)
  • response-adapted treatment
  • METABOLIC TUMOR VOLUME
  • RESPONSE-ADAPTED THERAPY
  • BONE-MARROW BIOPSY
  • INTERIM FDG-PET
  • INTERNATIONAL HARMONIZATION PROJECT
  • BURDEN FOLLICULAR LYMPHOMA
  • PROGRESSION-FREE SURVIVAL
  • CONTRAST-ENHANCED CT
  • WHOLE-BODY
  • PROGNOSTIC VALUE

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