Clinical value of 18F-FDG PET/CT in the management of HIV-associated lymphoma

Abstract

HIV is still a major public health problem. At present, HIV-associated lymphoma remains the leading cause of deaths among people living with HIV, which should be paid more attention to. 18F-fluorodeoxglucose (FDG) PET/CT has been recommended in the initial staging, restaging, response assessment and prognostic prediction of lymphomas in general population. HIV-associated lymphoma is, however, a different entity from lymphoma in HIV-negative with a poorer prognosis. The ability to accurately risk-stratify HIV-infected patients with lymphoma will help guide treatment strategy and improve the prognosis. In the review, the current clinical applications of 18F-FDG PET/CT in HIV-associated lymphoma will be discussed, such as diagnosis, initial staging, response evaluation, prognostic prediction, PET-guided radiotherapy decision, and surveillance for recurrence. Moreover, future perspectives will also be presented.

Recent advancements in 18F-FDG PET/CT for the diagnosis, staging, and treatment management of HIV-related lymphoma

“…18 F-FDG PET/CT is more effective than contrastenhanced CT in the early stages of lymphoma detection, particularly for lesions involving the gastrointestinal tract, spleen, and bone marrow that lack or have minimal anatomical abnormalities. 18 F-FDG PET/CT can produce a reliable map of probable disease and detect previously unrecognized areas of disease in the first stage of AIDSrelated Burkitt's lymphoma (BL) [14]. A retrospective examination of 13 HIV-positive BL patients who had at least one 18 F-FDG PET/CT scan was done by Just et al [16].…”

“…ing. When using 18 F-FDG PET/CT for early detection of HIVrelated lymphoma, the possibility of false-positive results owing to benign lymphadenopathy must be fully considered [14,17]. In establishing the potential etiology of lymphadenopathy, valuable indicators include clinical manifestations, CD4 counts, radiological characteristics, and PET metabolic parameters.…”

“…However, there are incredibly few 18 F-FDG PET/CT studies with small statistical populations available currently for the early staging of HIV-related lymphoma. More extensive sample sizes will be needed for future research [14]. A summary of the significance of 18 F-FDG PET/CT in HIV-related lymphoma staging and diagnosis is provided in Table 1.…”

“…FDG-PET at the end of the therapy for DLBCL can assist in identifying patients who might gain an advantage from more intensive treatment. Following the end result of the intended treatment, viable tumour cells can be distinguished from fibrosis or necrosis using an 18 F-FDG-PET/CT scan [14]. The German Hodgkin Study Group (GHSG) HD15 trial enrolled 2182 HL patients.…”

“…It remains debatable whether HIV infection increases tumor burden and decreases overall survival. Limited research has been conducted to date regarding the clinical utility of 18 F-FDG PET/CT in the context of HIV-related lymphoma [14]. This review will start with an overview of the Subtypes, risk factors, and therapeutic choices for individuals with HIV-related lymphoma.…”