FDG-PET/CT in the Monitoring of Lymphoma Immunotherapy Response: Current Status and Future Prospects

Abstract

Cancer immunotherapy has been extensively investigated in lymphoma over the last three decades. This new treatment modality is now established as a way to manage and maintain several stages and subtypes of lymphoma. The establishment of this novel therapy has necessitated the development of new imaging response criteria to evaluate and follow up with cancer patients. Several FDG PET/CT-based response criteria have emerged to address and encompass the various most commonly observed response patterns. Many of the proposed response criteria are currently being used to evaluate and predict responses. The purpose of this review is to address the efficacy and side effects of cancer immunotherapy and to correlate this with the proposed criteria and relevant patterns of FDG PET/CT in lymphoma immunotherapy as applicable. The latest updates and future prospects in lymphoma immunotherapy, as well as PET/CT potentials, will be discussed.

Differentiating Hodgkin Lymphoma and Sarcoid Reaction in Subsequent FDG-PET/CT: A Case Report and Literature Review

“…Antineoplastic treatment of either hematologic or solid tumors has also been observed to either cause the onset or flare-up of sarcoidosis activity. 13 Sarcoid reactions are sometimes associated with cancer. Sarcoid reactions are the development of noncaseating epithelioid cell granulomas in patients who do not meet the systemic sarcoidosis criteria.…”

A comprehensive review of the role of bone marrow biopsy and PET-CT in the evaluation of bone marrow involvement in adults newly diagnosed with DLBCL

“…PET-CT exhibits an enhanced utility in the context of DLBCL therapeutic advancements, particularly with the increased use of immunotherapy. The use of PET-CT in DLBCL has added significant value in initial diagnosis, staging, assessment of extra-nodal uptake, response assessment, and has further extended to the ability to detect signs of toxicities related to immunotherapy, such as inflammatory reactions, reactive changes, and tumor flare reactions ( 51 ). PET-CT has also had an important role in assessment of response to therapy, using several metrics to distinguish between different types of response, pseudo-progression, and progression ( 51 ).…”

PET/CT in leukemia: utility and future directions

“…Chimeric antigen receptor (CAR-T) cells are a crucial component of leukemia immunotherapy [7]. Wang et al conducted a study demonstrating the feasibility of labeling CAR-T cells with [ 68 Ga]Ga-oxine for in-vivo tracking through PET imaging [141].…”

“…Chimeric antigen receptor (CAR-T) cells are a crucial component of leukemia immunotherapy [7]. Wang et al .…”

“…The utilization of 2-deoxy-2-[ 18 F]fluoro-d-glucose or 2-[ 18 F]fluoro-2-deoxy-d-glucose PET/computed tomography ([ 18 F]FDG PET/CT) in hematologic malignancies has been recently on the rise in the era of immunotherapy and novel agents [7]. In particular, the application of [ 18 F]FDG PET/CT has become very popular as a novel, noninvasive molecular imaging modality for the identification, staging, restaging, and evaluation of therapeutic response in hematologic malignancies, including lymphoma, myeloid sarcoma, and multiple myeloma [8][9][10][11].…”