Abstract

Lymphomas are heterogeneous but potentially curable group of neoplasms. Treatment of lymphomas has rapidly evolved overtime with significant improvement in the cure rate and reductions in treatment-related toxicities. Despite excellent results, treatment programs are continued to be developed to achieve better curative and safety profiles. In these patients individualized therapy schemes can be devised based on a well-defined risk categorization. The therapy efficacy can be increased early during therapy in non-responding patients with escalated therapy protocols or with the addition of radiation therapy, particularly, in advanced-stage or unfavorable risk patients. The increasing availability of positron emission tomography using 18F-fluorodeoxyglucose, particularly fused with computed tomography (FDG-PET/CT) has lead to the integration of this modality into the routine staging and restaging for lymphoma with convincing evidence that it is a more accurate imaging modality compared with conventional imaging techniques. FDG-PET/CT is also is a promising surrogate for tumor chemosensitivity early during therapy. This review will summarize published data on the utility of FDG-PET/CT imaging in the staging, restaging, and predicting therapy response in patients with lymphoma.

Highlights

  • The lymphomas are a heterogeneous group of diseases with respect to their biology, treatment, and prognosis

  • HISTOPATHOLOGIC LYMPHOMA SUBTYPES F-18-fluorodeoxyglucose-avidity varies among the various lymphoma subtypes, the most routinely avid being Hodgkin lymphoma (HL), diffuse large B-cell lymphoma (DLBCL), Burkitt, mantle cell (MCL), follicular lymphoma (FL) with a Positron emission tomography (PET)/computed tomography (CT) sensitivity of 85–100% [1,2,3,4,5,6]

  • FDG-PET/CT in lymphoma widespread use of systemic chemotherapy in lymphoma patients appears to mitigate the need for a precise determination of the anatomic extent of disease; staging PET/CT is integral to evaluation of subsequent response to therapy

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Summary

INTRODUCTION

The lymphomas are a heterogeneous group of diseases with respect to their biology, treatment, and prognosis. Despite the high rate of cure of Hodgkin lymphoma (HL) and diffuse large B-cell lymphoma (DLBCL), there is a need to alter therapy in patients unlikely to benefit from standard treatment, while reducing treatment intensity in patients with low risk disease. To achieve this goal requires an accurate staging system, but strong baseline risk factors (prognostic), and/or those early during therapy (predictive factors) to define the optimal treatment strategy. It is important to realize that the www.frontiersin.org

Kostakoglu and Cheson
GENERAL CONSIDERATIONS AND RECOMMENDATIONS
Newly Diagnosed Diffuse Large
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