Predictive value of pre-treatment FDG PET in patients with non-Hodgkin lymphoma treated with radioimmunotherapy: a systematic review

  • Silvia MorbelliEmail author
  • Selene Capitanio
  • Luca Guerra
  • Luigi Rigacci
Systematic Review
Part of the following topical collections:
  1. Lymphatic and hematological system



We aimed to systematically review studies addressing the value of baseline FDG PET as predictive biomarker for response to RIT in patients with NHL.


We searched (last update: March 2019) the databases PubMed, PMC, Google Scholar and Medline using both as text and as MeSH (Medical Subject Headings) terms the following: “positron emission tomography—PET”, “PET/CT”, “FDG”, “18F-fluorodeoxyglucose”, and “radioimmunotherapy”, ‘90Y-ibritumomab tiuxetan” and “non-Hodgkin lymphoma” and “follicular lymphoma”. Among all the retrieved articles, we selected only those specifically analyzing role, predictive and overall value of pretreatment FDG PET in patients with NHL submitted to RIT.


The initial search retrieved seventy articles, however, only eight specifically analyzed the predictive value of pretreatment FDG PET in patients with NHL submitted to RIT and were thus discussed. Eight studies in 254 patients evaluated the role of FDG PET as a predictor of response prior to RIT. Despite several methodological issues, patients- and lesion-based analyses carried out to-date seem to suggest a relevant prognostic role of both morphological computed tomography and metabolic imaging.


Although it is still not possible to specifically define the best PET-based predictor (i.e. SUVmax, TLG, MTV), FDG-PET is a promising tool for a more accurate and individualized selection of NHL patients candidates to RIT. The availability of FDG PET examinations in homogenous group of patients included in already completed clinical trials might be used in the next future also to specifically assess the prognostic value of baseline FDG PET in patients treated with RIT based on the study design.


Positron emission tomography 18F-FDG Radioimmunotherapy 90Y-ibritumomab tiuxetan 


Author contributions

SM and SC: literature search and review, manuscript writing. LG and LR manuscript writing and editing.


This study was not funded by grants.

Compliance with ethical standards

Conflict of interest

SM received speaker honoraria from General Electric and Eli-Lilly. The other authors declare no conflict of interest.

Statement of human rights

As a review this statement is not mandatory.


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Copyright information

© Italian Association of Nuclear Medicine and Molecular Imaging 2019

Authors and Affiliations

  • Silvia Morbelli
    • 1
    • 2
    Email author
  • Selene Capitanio
    • 1
    • 2
  • Luca Guerra
    • 3
  • Luigi Rigacci
    • 4
  1. 1.Nuclear Medicine UnitIRCCS Ospedale Policlinico San MartinoGenoaItaly
  2. 2.Nuclear Medicine Unit, Department of Health SciencesUniversity of GenoaGenoaItaly
  3. 3.Nuclear Medicine UnitSan Gerardo HospitalMonzaItaly
  4. 4.UO Ematologia e Centro Trapianti Cellule Staminali, AO San Camillo ForlaniniRomeItaly

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