FDG-PET/CT in Lymphoma: Where Do We Go Now?

Tabaa, Yassine Al; Bailly, Clément; Kanoun, Salim

doi:10.3390/cancers13205222

Cited by 19 publications

(9 citation statements)

References 122 publications

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“…Interestingly, TMTV seems to be a potential prognostic biomarker, since a larger tumor volume is associated with a more severe cytokine release syndrome. However, further research is required to corroborate these conclusions [ 101 ].…”

Section: An Overview Of Metabolic Biomarkers In B-cell Lymphomasmentioning

confidence: 99%

“…As a biomarker for the early success or failure of R-CHOP in several trials, interim PET has been evaluated as a possible biomarker for those patients who will not benefit from first-line therapy. FDG-PET also plays an important role in the treatment of patients who are resistant to chemotherapy and may benefit from medicines with various mechanisms of action [ 101 ].…”

Section: The Novel and Future Therapeutic Aspect For B-cell Lymphomamentioning

confidence: 99%

“…This strategy incorporates the possibility of pseudo-progression reported with checkpoint inhibitors and also with immune modulators in general in order to avoid discontinuing a therapy that is actually effective and mandates additional biopsies or reimaging after 12 weeks [ 123 ]. Thus, novel FDG-PET/CT criteria are being created to evaluate the response to novel immunotherapy regimens and to serve as a more accurate predictive biomarker for predicting patient survival [ 101 ].…”

Section: The Novel and Future Therapeutic Aspect For B-cell Lymphomamentioning

confidence: 99%

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Metabolic Biomarkers in B-Cell Lymphomas for Early Diagnosis and Prediction, as Well as Their Influence on Prognosis and Treatment

et al. 2022

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B-cell lymphomas exhibit a vast variety of clinical and histological characteristics that might complicate the diagnosis. Timely diagnosis is crucial, as treatments for aggressive subtypes are considered successful and frequently curative, whereas indolent B-cell lymphomas are incurable and often need several therapies. The purpose of this review is to explore the current advancements achieved in B-cell lymphomas metabolism and how these indicators help to early detect metabolic changes in B-cell lymphomas and the use of predictive biological markers in refractory or relapsed disease. Since the year 1920, the Warburg effect has been known as an integral part of metabolic reprogramming. Compared to normal cells, cancerous cells require more glucose. These cancer cells undergo aerobic glycolysis instead of oxidative phosphorylation to metabolize glucose and form lactate as an end product. With the help of these metabolic alterations, a novel biomass is generated by the formation of various precursors. An aggressive metabolic phenotype is an aerobic glycolysis that has the advantage of producing high-rate ATP and preparing the biomass for the amino acid, as well as fatty acid, synthesis needed for a rapid proliferation of cells, while aerobic glycolysis is commonly thought to be the dominant metabolism in cancer cells. Later on, many metabolic biomarkers, such as increased levels of lactate dehydrogenase (LDH), plasma lactate, and deficiency of thiamine in B-cell lymphoma patients, were discovered. Various kinds of molecules can be used as biomarkers, such as genes, proteins, or hormones, because they all refer to body health. Here, we focus only on significant metabolic biomarkers in B-cell lymphomas. In conclusion, many metabolic biomarkers have been shown to have clinical validity, but many others have not been subjected to extensive testing to demonstrate their clinical usefulness in B-cell lymphoma. Furthermore, they play an essential role in the discovery of new therapeutic targets.

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Section: An Overview Of Metabolic Biomarkers In B-cell Lymphomasmentioning

confidence: 99%

Section: The Novel and Future Therapeutic Aspect For B-cell Lymphomamentioning

confidence: 99%

Section: The Novel and Future Therapeutic Aspect For B-cell Lymphomamentioning

confidence: 99%

See 1 more Smart Citation

Metabolic Biomarkers in B-Cell Lymphomas for Early Diagnosis and Prediction, as Well as Their Influence on Prognosis and Treatment

et al. 2022

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“…Hematological malignancies affect a significant number of patients worldwide each year, for which timely diagnosis and treatment are crucial [ 1 , 2 ]. Although fluorine-18 fluorodeoxyglucose ([ 18 F]FDG) remains the leading positron emission tomography (PET) tracer for routine clinical work-up in many neoplasms and in such hematological malignancies, there is an increasing demand for more specific tracers targeting other metabolic pathways to guide early effective treatment strategies [ 3 , 4 , 5 ]. In this setting, the role of this imaging modality for the initial assessment, post-therapeutic evaluation, and prognostic value has been clearly demonstrated for both Hodgkin lymphoma (HL) and non-HL (NHL), such as diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Emerging Role of [18F]FLT PET/CT in Lymphoid Malignancies: A Review of Clinical Results

Nappi,

Santo,

Jonghi-Lavarini

et al. 2024

Hematology Reports

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Fluorine-18 fluorodeoxyglucose ([18F]FDG) is nowadays the leading positron emission tomography (PET) tracer for routine clinical work-ups in hematological malignancies; however, it is limited by false positive findings. Notably, false positives can occur in inflammatory and infective cases or in necrotic tumors that are infiltrated by macrophages and other inflammatory cells. In this context, 3′-deoxy-3′-[18F]fluorothymidine ([18F]FLT) has been shown to be a promising imaging biomarker of hematological malignant cell proliferation. In this review, a total of 15 papers were reviewed to collect literature data regarding the clinical application of [18F]FLT PET/CT in hematological malignancies. This imaging modality seems to be a suitable tool for noninvasive assessment of tumor grading, also showing a correlation with Ki-67 immunostaining. Moreover, [18F]FLT PET/CT demonstrated high sensitivity in detecting aggressive lymphoma lesions, especially when applying a standardized uptake value (SUV) cutoff of 3. At baseline, the potential of [18F]FLT imaging as a predictive tool is demonstrated by the low tracer uptake in patients with a complete response. However, its use is limited in evaluating bone diseases due to its high physiological uptake in bone marrow. Interim [18F]FLT PET/CT (iFLT) has the potential to identify high-risk patients with greater precision than [18F]FDG PET/CT, optimizing risk-adapted therapy strategies. Moreover, [18F]FLT uptake showed a greater ability to differentiate tumor from inflammation compared to [18F]FDG, allowing the reduction of false-positive findings and making the first one a more selective tracer. Finally, FLT emerges as a superior independent predictor of PFS and OS compared to FDG and ensures a reliable early response assessment with greater accuracy and predictive value.

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“…Lymphoma is routinely assessed by [ 18 F]FDG positron emission tomography (PET/CT) for initial staging and following the therapy with Lugano classification. The main limitation of Lugano criteria with a high false-positive rate of FDG avid lesions is well recognized (Al Tabaa et al 2021 ; Younes et al 2017 ), with a false-positive proportion of 42.9% from meta-analysis (Adams and Kwee 2019 ). Although current NCCN guidelines indicate treatment intensification without a necessary confirmatory biopsy with elevated Deauville score, it is important to identify non-neoplastic conditions of increased [ 18 F]FDG avidity, including chemotherapy-induced inflammatory process due to extensive tumor necrosis.…”

Section: Introductionmentioning

confidence: 99%

Foreign body-type giant cell reaction with extensive granulation tissue and intense inflammation after chemotherapy mimicking residual lymphoma on FDG PET

Kazi

Raptis

Abbaspour

et al. 2022

European J Hybrid Imaging

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Foreign body-type giant cell reaction is typically a biological and immunological reaction to the presence of foreign bodies such as catheters, parasites or biomaterials with a collection of fused macrophages (giant cell). We reported an unusual case of [18F]FDG PET findings in diffuse large B cell lymphoma in the urinary bladder following incomplete resection and chemotherapy. As the restaging [18F]FDG PET showed intense [18F]FDG uptake in the urinary bladder at the resection site concerning for recurrence, the lesion was subsequently resected and histopathology showed extensive granulation tissue with foreign body-type giant cell reaction with no suspected foreign bodies or neoplasia.

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FDG-PET/CT in Lymphoma: Where Do We Go Now?

Cited by 19 publications

References 122 publications

Metabolic Biomarkers in B-Cell Lymphomas for Early Diagnosis and Prediction, as Well as Their Influence on Prognosis and Treatment

Metabolic Biomarkers in B-Cell Lymphomas for Early Diagnosis and Prediction, as Well as Their Influence on Prognosis and Treatment

Emerging Role of [18F]FLT PET/CT in Lymphoid Malignancies: A Review of Clinical Results

Foreign body-type giant cell reaction with extensive granulation tissue and intense inflammation after chemotherapy mimicking residual lymphoma on FDG PET

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