Department of Radiology and Nuclear Medicine, Deventer Ziekenhuis, Deventer, The Netherlands.
Department of Radiology and Nuclear Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Semin Oncol. 2017 Dec;44(6):404-419. doi: 10.1053/j.seminoncol.2018.01.005. Epub 2018 Apr 22.
Assessing response to therapy in lymphoma is important for determining patients' prognosis, guiding subsequent treatment, and may be used as an outcome measure of prognostic and therapeutic trials. Traditionally, computed tomography was the mainstay for response assessment and was predominantly performed at the end of treatment, whereas the most recent guidelines propose F-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) for this purpose. However, the value of FDG-PET performed during treatment (interim FDG-PET) is still a topic of debate. The purpose of this scientific communication is to provide an evidence-based overview of the value of interim FDG-PET in patients with lymphoma. The article first describes the development of imaging-based response assessment in lymphoma, the rationale and limitations of using FDG-PET for this purpose, and continues with the evidence-based clinical utility of interim FDG-PET in three major lymphoma subtypes (Hodgkin lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma), and finishes with conclusions and recommendations for standard care and future research.
评估淋巴瘤治疗反应对于确定患者预后、指导后续治疗非常重要,并且可以作为预后和治疗试验的结果衡量标准。传统上,计算机断层扫描(CT)是反应评估的主要手段,主要在治疗结束时进行,而最近的指南建议使用 F-氟代-2-脱氧-D-葡萄糖(FDG)正电子发射断层扫描(PET)进行评估。然而,治疗期间进行的 FDG-PET(中期 FDG-PET)的价值仍然存在争议。本科学交流的目的是提供基于证据的淋巴瘤患者中期 FDG-PET 价值概述。文章首先描述了淋巴瘤基于影像学的反应评估的发展,以及使用 FDG-PET 进行此目的的原理和局限性,然后介绍了中期 FDG-PET 在三种主要淋巴瘤亚型(霍奇金淋巴瘤、弥漫性大 B 细胞淋巴瘤和滤泡性淋巴瘤)中的基于证据的临床应用,并给出了标准护理和未来研究的结论和建议。