ABSTRACT
The Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is a functional and metabolic imaging modality with high sensitivity and accuracy for staging, restaging, and evaluation of response to treatment in Non-Hodgkin and Hodgkin lymphoma patients. Objective and accurate evaluation of treatment response in interim (iPET) and end of treatment (ePET) PET/CT is one of the most important parameters of patient management. In this review, standardization studies used in the evaluation of treatment response with PET/CT in lymphomas, the importance of iPET and ePET in patient management, metabolic tumor markers and pitfalls that can be followed in PET/CT after treatment were evaluated.
References
1Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021;71:209-249.
2Eude F, Toledano MN, Vera P, Tilly H, Mihailescu SD, Becker S. Reproducibility of Baseline Tumour Metabolic Volume Measurements in Diffuse Large B-Cell LymphomA: Is There a Superior Method? Metabolites 2021;11:72.
3Jhanwar YS, Straus DJ. The role of PET in lymphoma. J Nucl Med 2006;47:1326-1334.
4Kirby AM, Mikhaeel NG. The role of FDG PET in the management of lymphoma: what is the evidence base? Nucl Med Commun 2007;28:335-354.
5Meignan M. VI. FDG-PET as a biomarker in lymphoma: from qualitative to quantitative analysis. Hematol Oncol 2015;33:38-41.
6Türk Hematoloji Derneği. Lenfoma tanı ve tedavi kılavuzu. İstanbul, Ekim 2020.
7Khalifa N, Fawzy A. The Comparative analysis of PET/CT and Contrast CT in the Evaluation of Patients with Lymphoma. Egyptian J Nucl Med 2010;2:8-17.
8Cheson BD, Horning SJ, Coiffier B, et al. Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999;17:1244.
9Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol 2007;25:571-578.
10Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007;25:579-586.
11Meignan M, Gallamini A, Meignan M, Gallamini A, Haioun C. Report on the First International Workshop on Interim-PET-Scan in Lymphoma. Leuk Lymphoma 2009;50:1257-1260.
12Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014;32:3059-3068.
13Mamot C, Klingbiel D, Hitz F, et al. Final Results of a Prospective Evaluation of the Predictive Value of Interim Positron Emission Tomography in Patients With Diffuse Large B-Cell Lymphoma Treated With R-CHOP-14 (SAKK 38/07). J Clin Oncol 2015;33:2523-2529.
14Biggi A, Gallamini A, Chauvie S, et al. International validation study for interim PET in ABVD-treated, advanced-stage hodgkin lymphoma: interpretation criteria and concordance rate among reviewers. J Nucl Med 2013;54:683-690.
15Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: Evolving Considerations for PET response criteria in solid tumors. J Nucl Med 2009;50 Suppl 1:122-150.
16O JH, Lodge MA, Wahl RL. Practical PERCIST: A Simplified Guide to PET Response Criteria in Solid Tumors 1.0. Radiology 2016;280:576-584.
17Younes A, Hilden P, Coiffier B, et al. International Working Group consensus response evaluation criteria in lymphoma (RECIL 2017). Ann Oncol 2017;28:1436-1447.
18Berzaczy D, Haug A, Staber PB, et al. RECIL versus Lugano for Treatment Response Assessment in FDG-Avid Non-Hodgkin Lymphomas: A Head-to-Head Comparison in 54 Patients. Cancers (Basel) 2019;12:9.
19Cheson BD, Ansell S, Schwartz L, et al. Refinement of the Lugano Classification lymphoma response criteria in the era of immunomodulatory therapy. Blood 2016;128:2489-2496.
20Ferrari C, Maggialetti N, Masi T, et al. Early Evaluation of Immunotherapy Response in Lymphoma Patients by 18F-FDG PET/CT: A Literature Overview. J Pers Med 2021;11:217.
21Ha CS, LeBlanc M, Schöder H, et al. Potential impact of consolidation radiation therapy for advanced Hodgkin lymphoma: a secondary analysis of SWOG S0816. Leuk Lymphoma 2020;61:2442-2447.
22Moghbel MC, Mittra E, Gallamini A, et al. Response Assessment Criteria and Their Applications in Lymphoma: Part 2. J Nucl Med 2017;58:13-22.
23Armitage JO, Gascoyne RD, Lunning MA, Cavalli F. Non-Hodgkin lymphoma. Lancet 2017;390:298-310.
24Press OW, Li H, Schöder H, et al. US Intergroup Trial of Response-Adapted Therapy for Stage III to IV Hodgkin Lymphoma Using Early Interim Fluorodeoxyglucose-Positron Emission Tomography Imaging: Southwest Oncology Group S0816. J Clin Oncol 2016;34:2020-2027.
25Zijlstra JM, Lindauer-van der Werf G, Hoekstra OS, Hooft L, Riphagen II, Huijgens PC. 18F-fluoro-deoxyglucose positron emission tomography for post-treatment evaluation of malignant lymphoma: a systematic review. Haematologica 2006;91:522-529.
26Barnes JA, LaCasce AS, Zukotynski K, et al. End-of-treatment but not interim PET scan predicts outcome in nonbulky limited-stage Hodgkin’s lymphoma. Ann Oncol 2011;22:910-915.
27Terasawa T, Nihashi T, Hotta T, Nagai H. 18F-FDG PET for posttherapy assessment of Hodgkin’s disease and aggressive Non-Hodgkin’s lymphoma: a systematic review. J Nucl Med 2008;49:13-21.
28Zinzani PL, Rigacci L, Stefoni V, et al. Early interim 18F-FDG PET in Hodgkin’s lymphoma: evaluation on 304 patients. Eur J Nucl Med Mol Imaging 2012;39:4-12.
29Rigacci L, Puccini B, Broccoli A, et al. Clinical characteristics of interim-PET negative patients with a positive end PET from the prospective HD08-01 FIL study. Ann Hematol 2020;99:283-291.
30Khong PL, Huang B, Lee EY, Chan WK, Kwong YL. Midtreatment ¹⁸F-FDG PET/CT Scan for Early Response Assessment of SMILE Therapy in Natural Killer/T-Cell Lymphoma: A Prospective Study from a Single Center. J Nucl Med 2014;55:911-916.
31Li YJ, Li ZM, Xia XY, et al. Prognostic value of interim and posttherapy 18F-FDG PET/CT in patients with mature T-cell and natural killer cell lymphomas. J Nucl Med 2013;54:507-515.
32Xie W, Liu MK, Jiang XF, et al. Improved prediction of chemoresistance in patients with diffuse large B-cell lymphoma through a new interim positron emission tomography-computed tomography evaluation model. Acta Oncol 2021:1-9.
33Stephens DM, Li H, Schöder H, et al. Five-year follow-up of SWOG S0816: limitations and values of a PET-adapted approach with stage III/IV Hodgkin lymphoma. Blood 2019;134:1238-1246.
34Zaman MU, Fatima N, Zaman A, Zaman U, Zaman S, Tahseen R. Progression Free Survival and Predictor of Recurrence in DLBCL patients with Negative Interim 18FDG PET/CT Using Standardized Imaging and Reporting Protocols. Asian Pac J Cancer Prev 2020;21:2343-2348.
35Tokola S, Kuitunen H, Turpeenniemi-Hujanen T, Kuittinen O. Interim and end-of-treatment PET-CT suffers from high false-positive rates in DLBCL: Biopsy is needed prior to treatment decisions. Cancer Med 2021;10:3035-3044.
36Poulou LS, Thanos L, Ziakas PD. Unifying the predictive value of pretransplant FDG PET in patients with lymphoma: a review and meta-analysis of published trials. Eur J Nucl Med Mol Imaging 2010;37:156-162.
37Gupta N, Singh N. To evaluate prognostic significance of metabolic-derived tumour volume at staging 18-flurodeoxyglucose PET-CT scan and to compare it with standardized uptake value-based response evaluation on interim 18-flurodeoxyglucose PET-CT scan in patients of non-Hodgkin’s lymphoma (diffuse large B-cell lymphoma). Nucl Med Commun 2020;41:395-404.
38Zucca E, Cascione L, Ruberto T, et al. Prognostic models integrating quantitative parameters from baseline and interim positron emission computed tomography in patients with diffuse large B-cell lymphoma: post-hoc analysis from the SAKK38/07 clinical trial. Hematol Oncol 2020;38:715-725.
39Hasenclever D, Kurch L, Mauz-Körholz C, et al. qPET - a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma. Eur J Nucl Med Mol Imaging 2014;41:1301-1308.
40Georgi TW, Kurch L, Hasenclever D, et al. Quantitative assessment of interim PET in Hodgkin lymphoma: An evaluation of the qPET method in adult patients in the RAPID trial. PLoS One 2020;15:e0231027.
41Schöder H, Moskowitz CH. Metabolic Tumor Volume in Lymphoma: Hype or Hope? J Clin Oncol 2016;34:3591-3594.
42Dubreuil J, Salles G, Bozzetto J, et al. Usual and unusual pitfalls of 18F-FDG-PET/CT in lymphoma after treatment: a pictorial review. Nucl Med Commun 2017;38:563-576.
