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Role of FDG PET/CT Imaging in Lymphoma: Response to Therapy

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Role of FDG PETT in lymphoma in response to therapy.

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Our role as imagers in response to therapy in patients

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with lymphoma is to evaluate the changes in intensity

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of tracer uptake

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or FDG in the areas of disease, as well

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as e evaluate areas of new disease, if there are any.

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There's a scale that we usually use

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and it's called DVL score,

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and this is an internationally recommended scale

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for reporting based on clinical trials.

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This can be used for Hodgkin's lymphoma

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and certain types of non-Hodgkin's lymphoma.

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For example, diffuse large B-cell lymphoma, marginal zone

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lymphoma, C-L-L-S-L-L,

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and mycosis fungoides for instance.

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There are some that have a separate criteria which will not

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be covered in these, but essentially would be those

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that are primarily extra nodal lymphoma

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or cutaneous lymphoma.

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So the scale that we use is essentially comparing the degree

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of uptake in the disease to compared

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to the degree of uptake in the mediastinum or liver.

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We use SUV max.

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Uh, so whenever we apply our volume of interest,

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we'll be using that number as a quantitative measurement,

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but the scale itself is visual also

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as a response criteria.

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There's the clinical lugano criteria, not the staging,

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but this would be the response.

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And these are classified as complete response, partial

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response, a stable disease in progression of disease.

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So whenever we say a double score of one

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through three, we are telling the clinician

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that this is a complete response,

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so it's clinically favorable.

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Whereas if the patient has a scale of they be four

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or five, it would be either partial response

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or stable disease would be, depending on the case, new areas

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of disease would fall into the progression

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of disease category.

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So these are how the clinical criteria

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and the imaging criteria merge,

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and it's important to keep in mind when you're reading these

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cases.

Report

Faculty

Elisa Franquet Elia, MD

Assistant Professor of Radiology

UMass Chan Medical School

Tags

Response and assessment

PET/CT FDG

PET

Oncologic Imaging

Nuclear Medicine

Neoplastic

Hematologic

General Oncologic Imaging Concepts