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Angewandte Nuklearmedizin 2022; 45(01): 20-27
DOI: 10.1055/a-1675-3441
Update Lymphome
Übersicht

PET/CT zur Beurteilung des Therapieansprechens bei aggressiven Lymphomen

PET/CT for the assessment of treatment response in malignant lymphoma
Jirka Grosse
1   Abteilung für Nuklearmedizin, Universitätsklinikum Regensburg, Regensburg, Deutschland
,
Dirk Hellwig
1   Abteilung für Nuklearmedizin, Universitätsklinikum Regensburg, Regensburg, Deutschland
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Zusammenfassung

Die Positronenemissionstomografie (PET) mit 18F-Fluorodesoxyglukose (FDG) in Kombination mit der Computertomografie (CT) ist integraler Bestandteil der initialen Diagnostik aggressiver Lymphome. Mehrere Studien und Metaanalysen haben gezeigt, dass die FDG-PET/CT die genaueste nicht invasive Methode bei Staging und Restaging von Hodgkin- (HL) und Non-Hodgkin-Lymphomen (NHL) darstellt. Die PET-basierte Risikostratifizierung liefert wesentliche prognostische Informationen. Im Laufe der letzten Jahre hat sich diese Hybridbildgebung auch zur frühen Beurteilung des Therapieansprechens und somit als Instrument der Therapiesteuerung etabliert. So kann auf Basis der FDG-Avidität von Restlymphomen das therapeutische Regime personifiziert ggf. eskaliert oder deeskaliert werden, um den Therapieerfolg zu verbessern. Neue PET-bildbasierte Biomarker wie das Metabolic Tumor Volume (MTV) lassen in naher Zukunft eine weitere Verbesserung dieser Risikostratifizierung erwarten. In der vorliegenden Übersichtsarbeit werden die relevanten Anwendungsbereiche der FDG-PET/CT bei der Beurteilung des Therapieansprechens maligner Lymphome dargestellt.

Abstract

Positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) in combination with computed tomography (CT) is an integral part of the initial staging of aggressive lymphomas. Several studies and meta-analyses have shown that FDG-PET/CT is the most accurate non invasive method in staging and restaging of Hodgkinʼs (HL) and non-Hodgkinʼs lymphoma (NHL). Essential prognostic information can be obtained in the context of PET-based risk stratification. In the last years, hybrid imaging has also been established for early assessment of therapy response and as a tool for therapy management. Thus, based on the FDG avidity of residual masses of lymphoma, the therapeutic regimen can be personalized and escalated or de-escalated to improve the outcome. New PET image-based biomarkers such as the metabolic tumor volume (MTV) are expected to further improve the risk stratification in the near future. In the present review, relevant applications of FDG-PET/CT for the assessment of treatment response in malignant lymphomas are presented.

Schlüsselwörter

Lymphom - 18F-Fluorodeoxyglucose - Positronen-Emissions-Tomografie - PET/CT - Restaging

Key words

Lymphoma - 18F-Fludeoxyglucose - PET - PET/CT - Response Assessment


Publication History

Article published online:
07 March 2022

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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