Stoevesandt Dietrich, Steglich Jonas, Bartelt Jörg M, Kurch Lars, McCarten Kathleen M, Flerlage Jamie E, Georgi Thomas W, Mauz-Körholz Christine, Cho Steve Y, Körholz Dieter, Kluge Regine, Kelly Kara M, Pelz Tanja, Vordermark Dirk, Hoppe Bradford S, Dieckmann Karin, Voss Stephan D
From the Department of Radiology, University Hospital Halle, Ernst-Grube-Strasse 40, 06120 Halle (Saale), Germany (D.S., J.S., J.M.B.); Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany (L.K., T.W.G., R.K.); Diagnostic Imaging and Pediatrics, Warren Alpert Medical School, Brown University, Providence, RI (K.M.M.); Department of Pediatric Radiology, Imaging and Radiation Oncology, Core-Rhode Island, Providence, RI (K.M.M.); Department of Oncology, St Jude Children's Research Hospital, Memphis, Tenn (J.E.F.); Department of Pediatric Hematology and Oncology, University Hospital Giessen-Marburg, Giessen, Germany (C.M.K., D.K.); Medical Faculty of the Martin Luther University of Halle-Wittenberg, Halle (Saale) Germany (C.M.K.); Department of Radiology, University of Wisconsin-Madison, Madison, Wis (S.Y.C.); Roswell Park Comprehensive Cancer Center, Buffalo, NY (K.M.K.); Department of Radiation Oncology, Medical Faculty of the Martin-Luther-University, Halle (Saale), Germany (T.P., D.V.); Department of Radiation Oncology, Mayo Clinic-Jacksonville, Jacksonville, Fla (B.S.H.); Department of Radio-Oncology, Medical University Vienna, Vienna, Austria (K.D.); and Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Mass (S.D.V.).
Radiology. 2025 Jan;314(1):e232650. doi: 10.1148/radiol.232650.
Staging of pediatric Hodgkin lymphoma is currently based on the Ann Arbor classification, incorporating the Cotswold modifications and the Lugano classification. The Cotswold modifications provide guidelines for the use of CT and MRI. The Lugano classification emphasizes the importance of CT and PET/CT in evaluating both Hodgkin lymphoma and non-Hodgkin lymphoma but focuses on adult patients. This article presents consensus guidelines that extend the traditional classifications used for adult Hodgkin lymphoma staging and provide rigorous definitions of lymph node groups based on MRI, CT, and fluorodeoxyglucose PET/CT findings. This allows consistent terminology and definitions, using metabolic and morphologic imaging to identify affected lymph nodes or extranodal regions and organs. The pattern of involvement, together with other individual risk factors, determines treatment strategy. In case of inadequate response to chemotherapy, radiation therapy is often required. Standardization of staging definitions for pediatric Hodgkin lymphoma is necessary for comparing treatment outcomes between North American and European clinical trials and a prerequisite for clear communication during tumor boards and central review. This comprehensive imaging atlas is intended to provide regional criteria for nodal involvement and to serve as a standardized guide for the anatomic assignment of lymph node involvement in pediatric Hodgkin lymphoma.
目前，儿童霍奇金淋巴瘤的分期基于安阿伯分类法，并纳入了科茨沃尔德修订版和卢加诺分类法。科茨沃尔德修订版为CT和MRI的使用提供了指导原则。卢加诺分类法强调了CT和PET/CT在评估霍奇金淋巴瘤和非霍奇金淋巴瘤中的重要性，但主要针对成年患者。本文提出了共识性指南，扩展了用于成人霍奇金淋巴瘤分期的传统分类方法，并根据MRI、CT和氟脱氧葡萄糖PET/CT的检查结果，对淋巴结组进行了严格定义。这使得能够使用代谢和形态学成像来识别受累淋巴结或结外区域及器官，从而实现术语和定义的一致性。受累模式以及其他个体风险因素决定了治疗策略。如果化疗反应不佳，通常需要进行放射治疗。儿童霍奇金淋巴瘤分期定义的标准化对于比较北美和欧洲临床试验的治疗结果是必要的，也是在肿瘤病例讨论和中心审查期间进行清晰沟通的前提条件。这本综合影像图谱旨在提供淋巴结受累的区域标准，并作为儿童霍奇金淋巴瘤淋巴结受累解剖定位的标准化指南。
