Abstract
Simple SummaryWe focus on the role and current applications of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in the management of lymphoma patients through improved staging or treatment response assessment or through early PET-driven therapeutic strategies, leading the way to a novel area of personalized medicine, optimizing disease control and toxicity. We discuss the potential future directions of innovative metabolic metrics that are being developed, notably to assess response to new immunotherapy regimens and to provide an improved prognostic factor for predicting patients’ survival. Finally, we present new radiopharmaceuticals developed following the identification of pathways or specific receptors in lymphomas, providing great opportunities for molecular imaging in treatment evaluation and management.18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is an essential part of the management of patients with lymphoma at staging and response evaluation. Efforts to standardize PET acquisition and reporting, including the 5-point Deauville scale, have enabled PET to become a surrogate for treatment success or failure in common lymphoma subtypes. This review summarizes the key clinical-trial evidence that supports PET-directed personalized approaches in lymphoma but also points out the potential place of innovative PET/CT metrics or new radiopharmaceuticals in the future.
Highlights
Over the past several decades, positron emission tomography coupled with computed tomography using 18F-fluorodeoxyglucose (FDG-PET/CT), a tracer of glucose metabolism, has been considered as state-of-the-art imaging and provided the most significant improvement compared to conventional imaging in staging lymphoma [1,2]
We focus on the current applications and future directions of FDGPET/CT in managing patients with lymphoma through the development of new metabolic metrics as well as new radiopharmaceuticals
A recent study reported the feasibility of PET imaging with radiolabeled programmed cell death-ligand 1 (PD-L1) monoclonal antibodies (mAbs) for the assessment of therapy in solid malignancies [121].Huge challenges remain in monitoring response to Chimeric antigen receptor (CAR)-T cells therapy
Summary
Over the past several decades, positron emission tomography coupled with computed tomography using 18F-fluorodeoxyglucose (FDG-PET/CT), a tracer of glucose metabolism, has been considered as state-of-the-art imaging and provided the most significant improvement compared to conventional imaging in staging lymphoma [1,2]. FDG-PET/CT evaluation offers a better staging than conventional CT especially for extra nodal involvement. New PET driven metrics may be implemented in treatment decisions as new prognostic factors calculated on PET/CT images provide an interesting additional value to known prognostic parameters in several lymphoma subtypes. We focus on the current applications and future directions of FDGPET/CT in managing patients with lymphoma through the development of new metabolic metrics as well as new radiopharmaceuticals
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