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Overview and recent advances in PET/CT imaging in lymphoma and multiple myeloma

      Highlights

      • PET/CT is recommended for initial evaluation and treatment response assessment of FDG-avid -lymphoma histotypes and MM.
      • Several large randomized trials support personalized treatment escalation and de-escalation according to PET response.
      • Standardized criteria (i.e. Deauville-score and Lugano-classification for lymphoma;IMPETUS for MM) improved PET interpretation.
      • Biomarkers, tumor burden delineation, radiomics, artificial intelligencemight improve risk-stratification and prognostication.

      Abstract

      Imaging in hematological diseases has evolved extensively over the past several decades.
      Positron emission tomography/computed tomography (PET/CT) with of 2-[18 F]-fluoro-2-deoxy-d-glucose ([18 F] FDG) is currently essential for accurate staging and for early and late therapy response assessment for all FDG-avid lymphoproliferative histologies. The widely adopted visual Deauville 5-point scale and Lugano Classification recommendations have recently standardized PET scans interpretation and improved lymphoma patient management.
      In addition [18 F] FDG-PET is routinely recommended for initial evaluation and treatment response assessment of Multiple Myeloma (MM) with significant contribution in risk-stratification and prognostication, although magnetic resonance imaging remains the Gold Standard for the assessment of bone marrow involvement.
      In this review, an overview of the role of [18 F] FDG-PET, in hematological malignancies is provided, particularly focusing on Hodgkin lymphoma (HL) and Diffuse Large B Cell Lymphoma (DLBCL), both in adult and pediatric populations, and MM, at each point of patient management. Potential alternative molecular imaging applications in this field, such as non-[18 F] FDG-tracers, whole body magnetic resonance imaging (WB-MRI), hybrid PET/MRI and emerging radiomics research are briefly presented.

      Keywords

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