Investigation of FDG-PET/CT imaging to guide biopsies in the detection of histological transformation of indolent lymphoma

Positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) has been successfully evaluated in the management of non-Hodgkin's lymphoma (NHL).(1-3) Histological transformation (HT) of indolent lymphoma is a dramatic event that occurs in 5-10% of the patients and carries a dismal prognosis.(4,5) Previous studies prove that indolent lymphoma entities show a lower FDG uptake when compared with aggressive lymphomas.(6-8) We therefore postulated that FDG-PET/CT identifies aggressive transformation sites and can guide biopsies.