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PET in Lymphoma

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Clinical Nuclear Medicine

Abstract

The management approach in Hodgkin (HL) and high-grade non-Hodgkin lymphomas (NHLs) has shifted toward reducing the toxicity and long-term adverse effects associated with treatment while maintaining favorable outcomes in low-risk patients. The availability of more effective therapies for lymphoma provides a rationale for accurate diagnostic tests and updated patient evaluation, staging, and response criteria. In this regard, positron emission tomography (PET) using fluorodeoxyglucose (FDG) with computed tomography (CT) has proved effective as a metabolic imaging tool with compelling evidence supporting its superiority over conventional modalities, particularly in staging and early evaluation of response, and is now integrated into the routine staging and restaging algorithm of lymphomas. A semiquantitative parameter for measuring tumor glucose metabolism, the maximum standardized uptake value (SUVmax), reflects aggressiveness of neoplasm and is proven to be an important survival predictor. Several quantitative metrics including metabolic tumor volume (MTV) and total lesion glycolysis (TLG) appears to be dependable and reproducible prognostic indicators. Additionally, the 5-point Deauville score (DS) has been recommended as a qualitative method for evaluating interim and end-of-treatment PET/CT results. This chapter summarizes the data on the proven and potential utility of PET/CT imaging for staging, response assessment, and restaging, describing current limitations of this imaging modality.

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Authors and Affiliations

  1. Nuclear Medicine, Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Nasrin Ghesani, Somali Gavane & Anthony Hafez

  2. Mount Sinai School of Medicine, New York, NY, USA

    Lale Kostakoglu

  3. Radiology, Nuclear Medicine and Molecular Imaging, Department of Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, VA, USA

    Lale Kostakoglu

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  1. Nasrin Ghesani
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  2. Somali Gavane
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  4. Lale Kostakoglu
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Correspondence to Nasrin Ghesani .

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  1. Department of Nuclear Medicine, Klinikum Westfalen - Knappschaftskrankenhaus Academic teaching hospital of the Ruhr University, Dortmund, Nordrhein-Westfalen, Germany

    Hojjat Ahmadzadehfar

  2. Department of Nuclear Medicine, Beta Klinik Bonn, Bonn, Germany

    Hans-Jürgen Biersack

  3. Division of Nuclear Medicine, Department of Radiology, Montefiore Medical Center, Bronx, NY, USA

    Leonard M. Freeman

  4. Albert Einstein College of Medicine, Bronx, NY, USA

    Lionel S. Zuckier

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Ghesani, N., Gavane, S., Hafez, A., Kostakoglu, L. (2020). PET in Lymphoma. In: Ahmadzadehfar, H., Biersack, HJ., Freeman, L., Zuckier, L. (eds) Clinical Nuclear Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-39457-8_23

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