Application of the Lugano Classification for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The PRoLoG Consensus Initiative (Part 2-Technical)

The aim of this initiative was to provide consensus recommendations from a consortium of academic and industry experts in the field of lymphoma and imaging for the consistent application of imaging assessment with the Lugano classification. Methods: Consensus was obtained through a series of meetings from July 2019 to October 2021 sponsored by the PINTaD (Pharma Imaging Network for Therapeutics and Diagnostics) as part of the ProLoG (PINTaD RespOnse criteria in Lymphoma wOrking Group) consensus initiative. Results: Consensus recommendations encompass all technical imaging aspects of the Lugano classification. Some technical considerations for PET/CT and diagnostic CT are clarified with regards to required imaging series and scan visits, as well as acquisition and reconstruction of PET images and influence of lesion size and background activity. Recommenda-tions are given on the role of imaging and clinical reviewers as well as on training and monitoring. Finally, an example template of an imaging case report form is provided to support efficient collection of data with Lugano Classification. Conclusion: Consensus recommendations are made to comprehensively address technical and imaging areas of inconsistency and ambiguity in the classification encountered by end users. Such guidance should be used to support standardized acqui-sition and evaluation with the Lugano 2014.

Automated summary

The aim of this initiative was to provide consensus recommendations for the consistent application of imaging assessment with the Lugano classification in the field of lymphoma and imaging. Consensus was obtained through a series of sponsored meetings, resulting in recommendations to clarify technical considerations and provide guidance on the role of imaging and clinical reviewers in the classification. An example template of an imaging case report form is also provided to support efficient data collection. These consensus recommendations address technical and imaging areas of inconsistency and ambiguity in the classification encountered by end users.