[Quantitative and qualitative evaluation of the interim PET/CT in lymphoma treatment in the prediction of complete metabolic response]

FDG-PET/CT for the Management of Post-Chemotherapy Residual Mass in Hodgkin lymphoma

Simple Summary

In the present review the authors report the predictive value of FDG/PET-CT (PET) on treatment outcome of Hodgkin lymphoma patients showing a post-chemotherapy residual mass, based on the published reports of PET-guided consolidation radiotherapy after different-intensity chemotherapy regimens such as ABVD or BEACOPP_escalated. A special focus will be dedicated to the role of PET for assessing patients with a residual mass during and after immunotherapy with immune checkpoint inhibitors. Finally, the interpretation criteria of PET will be also reviewed, and the role of alternative imaging techniques discussed.

Abstract

In the present review, the authors report the published evidence on the use of functional imaging with FDG-PET/CT in assessing the final response to treatment in Hodgkin lymphoma. Despite a very high overall Negative Predictive Value of post-chemotherapy PET on treatment outcome ranging from 94% to 86%, according to different treatment intensity, the Positive Predicting Value proved much lower (40–25%). In the present review the Authors discuss the role of PET to guide consolidation RT over a RM after different chemotherapy regimens, both in early and in advanced-stage disease. A particular emphasis is dedicated to the peculiar issue of the qualitative versus semi-quantitative methods for End-of Therapy PET scan interpretation. A short hint will be given on the role of FDG-PET to assess the treatment outcome after immune checkpoint inhibitors.