John Libbey Eurotext

Hématologie

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FDG-PET in the evaluation of lymphomas Volume 15, issue 4, juillet-août 2009

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Authors
Service de médecine nucléaire, CHU de Nantes, 5, allée de l’Île-Gloriette, 44093 Nantes, France, CRCNA Inserm U892, 9, quai Moncousu, 44093 Nantes cedex, France, Service de médecine nucléaire, CHU de Brest, 2, avenue Foch, 29609 Brest cedex, France, Service de médecine nucléaire, CHU de Grenoble, BP 217, 38043 Grenoble cedex, France, Inserm U877, 38041 Grenoble cedex 09, France, Service de médecine nucléaire, centre René-Gauducheau, 44805 Saint-Herblain, France

FDG-PET has become widely used in the management of patients with malignant lymphomas especially diffuse large B cell (DLBCL) and Hodgkin lymphomas (HL). The clearest role for FDG-PET is in restaging patients following the completion of therapy. Recommendations must be followed for the interpretation of images. FDG-PET is strongly encouraged during the initial assessment of the disease in patients with HL and DLBCL-NHL to assess the extent of the disease with higher sensitivity and specificity than CT and to facilitate the interpretation of equivocal post-therapy. If numerous studies have confirmed that mid-treatment PET scans predict clinical outcome, the impact of a change induced by early therapeutic FDG-PET remains to be determined and the criteria for interpreting the early assessment must be standardized. For other types of lymphoma, FDG-PET may be interesting to confirm the localized stages for patients with follicular lymphoma and to guide biopsy in a patient suffering from low-grade with clinical suspicion of aggressive transformation.