PET Scans for Staging and Restaging in Diffuse Large B-Cell and Follicular Lymphomas.
Positron emission tomography (PET)-CT was recommended in updated international guidelines for staging/restaging of diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL). In FL, PET was previously regarded as a research application only. This review concentrates on new publications related to PET in these diseases. In DLBCL, PET appears appropriate for staging using prognostic indices established with CT and baseline PET parameters, e.g. metabolic tumour volume, are prognostic of outcome. Early complete metabolic response (CMR) predicts end-of-treatment CMR with excellent prognosis. Patients without CMR at interim should not have treatment altered, but have a worse prognosis, and patients with other high risk features may need closer monitoring. The end-of-treatment scan is confirmed as the standard for remission assessment using Deauville criteria, which are also predictive for patients undergoing ASCT. In FL, PET is more sensitive for staging than CT but misses bone marrow involvement. PET-CT identifies patients at risk of progression after induction chemotherapy better than CT.
PET Imaging Centre at St Thomas' Hospital, Division of Imaging Sciences and Biomedical Engineering, King's College London, Westminster Bridge Road, London, SE1 7EH, UK. sally.barrington@kcl.ac.uk.
Sally F
SF
Barrington
Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK.
N George
NG
Mikhaeel
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D019788:Fluorodeoxyglucose F18 / Q000737:chemistry; D006801:Humans; D008224:Lymphoma, Follicular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18
Cancer staging; Computed tomography; Diagnostic imaging; Diffuse large B cell lymphoma; Follicular lymphoma; Positron emission tomography