Hutchings Martin
From the Department of Haematology, The Finsen Centre, Rigshospitalet, Copenhagen, Denmark.
Cancer J. 2018 Sep/Oct;24(5):215-222. doi: 10.1097/PPO.0000000000000336.
18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (FDG PET/CT) is currently the criterion standard of lymphoma imaging and recommended through all stages of Hodgkin lymphoma management. Accurate staging is important for risk stratification and initial choice of therapy and also for the planning of postchemoradiotherapy. 18-Fluoro-2-deoxy-D-glucose PET/CT frequently leads to upstaging and potentially a more intensive treatment. Visual-only assessment of staging and interim scans is being accompanied by quantitative and semiquantitative methods to measure metabolic tumor volume, total lesion glycolysis, and so on. It is still unclear if these methods significantly improve the value of FDG PET/CT by visual assessment only. Because of the good prognostic value of FDG PET/CT, a large number of studies have used interim FDG PET to tailor treatment to the individual patients, according to their early metabolic response rather than according to their pretreatment prognostic features. 18-Fluoro-2-deoxy-D-glucose PET/CT is standard of care for posttreatment response assessment but has no place in routine follow-up of Hodgkin lymphoma patients in remission.
18-氟-2-脱氧-D-葡萄糖正电子发射断层扫描/计算机断层扫描(FDG PET/CT)目前是淋巴瘤成像的标准方法,在霍奇金淋巴瘤治疗的各个阶段均被推荐使用。准确分期对于风险分层、初始治疗选择以及放化疗后的规划都很重要。18-氟-2-脱氧-D-葡萄糖PET/CT经常会导致分期上调,并可能采用更强化的治疗。仅通过视觉评估进行分期和中期扫描时,还会结合定量和半定量方法来测量代谢肿瘤体积、总病变糖酵解等。目前尚不清楚这些方法是否仅通过视觉评估就能显著提高FDG PET/CT的价值。由于FDG PET/CT具有良好的预后价值,大量研究已使用中期FDG PET根据个体患者的早期代谢反应而非预处理预后特征来进行个体化治疗。18-氟-2-脱氧-D-葡萄糖PET/CT是治疗后反应评估的标准治疗方法,但在缓解期霍奇金淋巴瘤患者的常规随访中并无作用。