El-Galaly Tarec Christoffer, Hutchings Martin
Department of Haematology, Aalborg University Hospital, Aalborg, Denmark.
Cancer Treat Res. 2015;165:125-46. doi: 10.1007/978-3-319-13150-4_5.
Optimal lymphoma management requires accurate pretreatment staging and reliable assessment of response, both during and after therapy. Positron emission tomography with computerized tomography (PET/CT) combines functional and anatomical imaging and provides the most sensitive and accurate methods for lymphoma imaging. New guidelines for lymphoma imaging and recently revised criteria for lymphoma staging and response assessment recommend PET/CT staging, treatment monitoring, and response evaluation in all FDG-avid lymphomas, while CT remains the method of choice for non-FDG-avid histologies. Since interim PET imaging has high prognostic value in lymphoma, a number of trials investigate PET-based, response-adapted therapy for non-Hodgkin lymphomas (NHL). PET response is the main determinant of response according to the new response criteria, but PET/CT has little or no role in routine surveillance imaging, the value which is itself questionable. This review presents from a clinical point of view the evidence for the use of imaging and primarily PET/CT in NHL before, during, and after therapy. The reader is given an overview of the current PET-based interventional NHL trials and an insight into possible future developments in the field, including new PET tracers.
淋巴瘤的最佳管理需要在治疗期间及治疗后进行准确的治疗前分期和可靠的疗效评估。正电子发射断层扫描与计算机断层扫描（PET/CT）结合了功能成像和解剖成像，为淋巴瘤成像提供了最敏感和准确的方法。淋巴瘤成像新指南以及最近修订的淋巴瘤分期和疗效评估标准推荐，对于所有FDG摄取阳性的淋巴瘤均采用PET/CT进行分期、治疗监测和疗效评估，而对于非FDG摄取阳性的组织学类型，CT仍然是首选方法。由于中期PET成像在淋巴瘤中具有较高的预后价值，多项试验正在研究基于PET的非霍奇金淋巴瘤（NHL）适应性治疗。根据新的疗效标准，PET反应是疗效的主要决定因素，但PET/CT在常规监测成像中作用很小或没有作用，其价值本身也值得怀疑。本综述从临床角度介绍了在NHL治疗前、治疗期间和治疗后使用成像尤其是PET/CT的证据。读者可以了解当前基于PET的NHL介入试验概况，并深入了解该领域未来可能的发展，包括新的PET示踪剂。
