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Advances in Hematology
Volume 2011 (2011), Article ID 430679, 6 pages
http://dx.doi.org/10.1155/2011/430679
Review Article

Interim FDG-PET Scan in Hodgkin's Lymphoma: Hopes and Caveats

1Department of Hematology, Grand Hôpital de Charleroi, Grand Rue, 3, 6000 Charleroi, Belgium
2Department of Nuclear Medecine, Université Catholique de Louvain, Cliniques Universitaires UCL de Mont Godinne, Yvoir, Belgium
3Department of Hematology, Université Catholique de Louvain, Cliniques Universitaires UCL de Mont Godinne, Yvoir, Belgium

Received 29 June 2010; Accepted 1 November 2010

Academic Editor: Emanuele Zucca

Copyright © 2011 M. André et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

FDG-PET has recently emerged as an important tool for the management of Hodgkins lymphoma. Although its use for initial staging and response evaluation at the end of treatment is well established, the place of interim PET for response assessment and subsequent treatment tailoring is still quite controversial. The use of interim PET after a few cycles of chemotherapy may allow treatment reduction for good responders, leading to lesser treatment toxicities as well as early treatment adaptation for bad responders with a potential higher chance for cure. Interpretation of interim PET is a rapidly moving field. Actually, visual interpretation is preferred over quantitative interpretation in this situation. The notion of minimal residual uptake emerged for faint persisting FDG uptake, but has evolved during the recent years. Guidelines using mediastinum and liver as references have been proposed at the expert meeting in Deauville 2009. Actually, several trials are ongoing both for localised and advanced disease to evaluate the FDG-PET potential for early treatment monitoring and tailoring. Until the results of these prospective randomized trials become available, treatment changes according to the interim PET results should remain inappropriate and limited to well-conducted clinical trials.