Interim FDG-PET/CT for Response Assessment of Lymphoma

Semin Nucl Med. 2023 May;53(3):371-388. doi: 10.1053/j.semnuclmed.2022.10.004. Epub 2022 Nov 12.

Abstract

The clinical use and prognostic value of interim FDG-PET/CT (iPET/CT), which is performed after treatment initiation but prior to its completion, varies by lymphoma subtype. Evidence supporting the prognostic value of iPET/CT is more robust for classical Hodgkin lymphoma (cHL), and in this lymphoma subtype, response-adapted treatment approaches guided by iPET/CT are a widely used standard of care for first-line therapy. The data supporting use of iPET/CT among patients with non-Hodgkin lymphoma (NHL) is less well-established, but failure to achieve complete metabolic response on iPET/CT is generally considered a poor prognostic factor with likely consequences for progression free survival. This review will present the available evidence supporting use of iPET/CT in lymphoma patients, particularly as it relates to prognostication and the ability to inform response-adapted treatment strategies. The latter will be addressed through a discussion on the major iPET-response adapted clinical trials with mention of ongoing trials. Special attention will be given to cHL and a few subtypes of NHL, including diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL), and peripheral T cell lymphoma (PTCL).

Publication types

  • Review

MeSH terms

  • Fluorodeoxyglucose F18 / metabolism
  • Fluorodeoxyglucose F18 / therapeutic use
  • Hodgkin Disease* / diagnostic imaging
  • Hodgkin Disease* / therapy
  • Humans
  • Lymphoma, Large B-Cell, Diffuse*
  • Positron Emission Tomography Computed Tomography
  • Positron-Emission Tomography
  • Prognosis

Substances

  • Fluorodeoxyglucose F18