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2016 ; 30
(4
): 317-31
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FDG-PET imaging in hematological malignancies
#MMPMID27090170
Valls L
; Badve C
; Avril S
; Herrmann K
; Faulhaber P
; O'Donnell J
; Avril N
Blood Rev
2016[Jul]; 30
(4
): 317-31
PMID27090170
show ga
The majority of aggressive lymphomas is characterized by an up regulated
glycolytic activity, which enables the visualization by F-18 FDG-PET/CT. One-stop
hybrid FDG-PET/CT combines the functional and morphologic information,
outperforming both, CT and FDG-PET as separate imaging modalities. This has
resulted in several recommendations using FDG-PET/CT for staging, restaging,
monitoring during therapy, and assessment of treatment response as well as
identification of malignant transformation. FDG-PET/CT may obviate the need for a
bone marrow biopsy in patients with Hodgkin's lymphoma and diffuse large B cell
lymphoma. FDG-PET/CT response assessment is recommended for FDG-avid lymphomas,
whereas CT-based response evaluation remains important in lymphomas with low or
variable FDG avidity. The treatment induced change in metabolic activity allows
for assessment of response after completion of therapy as well as prediction of
outcome early during therapy. The five-point scale Deauville Criteria allows the
assessment of treatment response based on visual FDG-PET analysis. Although the
use of FDG-PET/CT for prediction of therapeutic response is promising it should
only be conducted in the context of clinical trials. Surveillance FDG-PET/CT
after complete remission is discouraged due to the relative high number of
false-positive findings, which in turn may result in further unnecessary
investigations. Future directions include the use of new PET tracers such as F-18
fluorothymidine (FLT), a surrogate biomarker of cellular proliferation and Ga-68
CXCR4, a chemokine receptor imaging biomarker as well as innovative digital
PET/CT and PET/MRI techniques.
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