Best Research Developments in Radiology: 2011

Hossein Jadvar, MD, PhD, MPH, MBA


November 23, 2011

In This Article

FDG PET/CT for Early Response Assessment in Diffuse Large B-cell Lymphoma

Cashen AF, Dehdashti F, Luo J, et al. 18F-FDG PET/CT for early response assessment in diffuse large B-cell lymphoma: poor predictive value of International Harmonization Project interpretation. J Nucl Med. 2011;52:386-392.


Use of FDG-PET in assessment of response after completion of chemotherapy in patients with lymphoma is now commonplace. The International Harmonization Project (IHP) for Response Criteria in Lymphoma has provided criteria for definition of response using end-of-therapy FDG-PET scan.[1,2] This prospective investigation focused on assessing whether applying the IHP criteria to mid-treatment FDG-PET/CT may be predictive of outcome in patients with stage III or IV diffuse large B-cell lymphoma. On the basis of the findings of this report, the authors recommend that interim FDG-PET/CT should be performed only in the context of clinical trials and should not be used to make treatment decisions in routine clinical practice. What will be needed is the development of criteria for the interpretation of interim FDG-PET/CT scans to determine whether positive scans can clearly identify poor-risk patients. Identification of such patients would allow early termination of futile therapy (and limit its toxicity) and the start of potentially more effective therapy.


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