The Usefulness of 2-[18F]FDG PET or PET/CT in Extranodal Natural Killer/T-Cell Lymphoma: A Systematic Review and Meta-Analysis.

Extranodal NK-/T-cell lymphoma (ENKTCL) is a rare and highly aggressive lymphoma with a bad prognosis. The aim of our analysis is to evaluate existing research on the potential usefulness of fluorine-18-fluorodeoxyglucose positron emission tomography or positron/computed tomography (2-[18F]FDG PET or PET/CT) in the management of patients with ENKTCL. A complete search of the literature was conducted across Scopus, PubMed/MEDLINE, and Embase databases, focusing on articles published up to March 2025. A total of 21 studies that investigated the role of 2-[18F]FDG PET or PET/CT in ENKTCL were included in our analysis. The main findings from the literature analysis were (1) 2-[18F]FDG PET/CT seems to be helpful in staging settings, showing a better diagnostic performance than conventional imaging and a positive impact on clinical stage; (2) 2-[18F]FDG PET/CT had excellent negative predictive value for detecting bone marrow involvement, especially in early-stage disease; and (3) qualitative and semiquantitative PET parameters might predict prognosis. Despite several limitations affecting this analysis, especially related to the heterogeneity of the studies included, 2-[18F]FDG PET/CT seems to be a useful tool for the evaluation of ENKTCL.