PET Imaging in Lymphoma

Guideline Objective

To provide a synthesis of the current evidence surrounding FDG PET/CT and provide recommendations with respect to PET in the diagnosis, staging, response evaluation, diagnosis of suspected recurrence, and routine follow-up of both HL and NHL.

Patient Population

Adult patients suspected of, with a diagnosis of, or recurrence of lymphoma including Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL).

Intended Guideline Users

To guide the Ontario PET Steering Committee in their decision making concerning indications for the use of PET imaging. This recommendation report may also be useful in informing clinical decision making regarding the appropriate role of PET imaging and in guiding priorities for future PET imaging research.

Research Question(s)

Diagnosis and Staging

1. What benefit to clinical management does 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) contribute to the initial diagnosis or staging of lymphoma?

Diagnosis of Recurrence and Routine Follow-Up

1. What benefit to clinical management does FDG PET/CT contribute after conventional imaging is performed, in patients with suspected or proven recurrence of lymphoma?
2. What benefit to clinical management does FDG PET/CT contribute to routine follow-up at the time of documented recurrence for lymphoma?

Response Evaluation (interim and at completion of therapy)

1. What benefit to clinical management does FDG PET/CT contribute to the interim assessment of treatment response and assessment of residual mass for lymphoma?