期刊
EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING
卷 44, 期 -, 页码 S97-S110出版社
SPRINGER
DOI: 10.1007/s00259-017-3690-8
关键词
Positron emission tomography; Lymphoma; Diagnosis; Therapy; Precisionmedicine
资金
- National Institute for Health Research Biomedical Research Centre of Guys & St. Thomas' NHS Trust in partnership
- King's College London
- King's College London and University College London Comprehensive Cancer Imaging Centre - Cancer Research UK
- Engineering and Physical Sciences Research Council in association
- Medical Research Council and Department of Health (England) [C1519/A16463]
- Cancer Research UK [16463] Funding Source: researchfish
- National Institute for Health Research [RP-2016-07-001] Funding Source: researchfish
PET using F-18-FDG for treatment monitoring in patients with lymphoma is one of the most well-developed clinical applications. PET/CT is nowadays used during treatment to assess chemosensitivity, with response-adapted therapy given according to 'interim' PET in clinical practice to adults and children with Hodgkin lymphoma. PET is also used to assess remission from disease and to predict prognosis in the pretransplant setting. Mature data have been reported for the common subtypes of aggressive B-cell lymphomas, with more recent data also supporting the use of PET for response assessment in T-cell lymphomas. The Deauville five-point scale incorporating the Deauville criteria (DC) is recommended for response assessment in international guidelines. FDG uptake is graded in relation to the reference regions of normal mediastinum and liver. The DC have been validated in most lymphoma subtypes. The DC permit the threshold for adequate or inadequate response to be adapted according to the clinical context or research question. It is important for PET readers to understand how the DC have been applied in response-adapted trials for correct interpretation and discussion with the multidisciplinary team. Quantitative methods to perform PET in standardized ways have also been developed which may further improve response assessment including a quantitative extension to the DC (qPET). This may have advantages in providing a continuous scale to refine the threshold for adequate/inadequate response in specific clinical situations or treatment optimization in trials. qPET is also less observer-dependent and limits the problem of optical misinterpretation due to the influence of background activity.
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