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Hematology

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PET-CT and PET-MRI in Oncology

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Malignant lymphoma is the most common hematologic malignancy and one of the most common malignant diseases in the general population. These lymphoproliferative disorders can be broadly divided into Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Patients with NHL have an especially poor prognosis with an average 5-year survival rate of 64%. NHL accounts for 2.6% of all cancer deaths. However, the 5-year survival has been gradually improving because of refinements in clinical management. Imaging has traditionally played a key role in the initial staging and surveillance of lymphoma. The first reports of PET for lymphoma imaging were published more than 20 years ago. Today 18F-FDG PET is the cornerstone of disease-staging in state-of-the-art management of HL and high grade NHL. In the past decades several studies investigated the value of PET/CT for the diagnosis and staging of lymphomas, and the great majority showed very high sensitivity and specificity in patients with HL and aggressive NHL. Greater variations have been reported in the sensitivity and specificity in patients with indolent lymphomas. PET is less commonly used for staging of these indolent lymphomas. Over the last few years, the efficacy of PET has been evaluated at all steps of lymphoma management including interim treatment monitoring, post-treatment response evaluation, and follow-up. Another important hematologic cancer is leukemia; however, even today, the role of functional (and morphologic) imaging in patients with leukemia is very limited. The role of PET/CT in multiple myeloma is evolving. PET/CT is superior to standard radiographic staging for multiple myeloma. It appears to be a prognostic marker for predicting outcome at baseline, after induction therapy and after transplantation for patients with multiple myeloma. Further studies may be necessary to validate these initial findings for incorporation of PET/CT in the guidelines for management of multiple myeloma.

R. M. Subramaniam, L. Prompers, and F. M. Mottaghy are contributed equally.

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Authors and Affiliations

  1. Boston University School of Medicine,  , Boston, MA , 02118, USA

    A. Agarwal

  2. Department of Nuclear Medicine, Maastricht University Medical Center, P. Debeylaan 25, 6229 HX, Maastricht, The Netherlands

    Leonne Prompers & Felix M. Mottaghy

  3. Department of Radiology Director, Quantitative Imaging Center (QIC), Boston University School of Medicine Section Chief, Musculoskeletal Imaging Boston Medical Center, 820 Harrison Avenue, Boston, MA , 02118, USA

    Ali Guermazi

  4. Clinic for Nuclear Medicine, University Hospital RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen,  Germany

    Felix M. Mottaghy

  5. Russell H Morgan Departments of Radiology and Radiological Sciences Institutions, The Johns Hopkins Medical Institutions, 601 N. Caroline Street/ JHOC 3235, Baltimore , MD, 21287, USA

    Rathan M. Subramaniam

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  1. Rathan M. Subramaniam
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Correspondence to Felix M. Mottaghy .

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  1. Rochester, 55901, Minnesota, USA

    Patrick Peller

  2. , Division of Neuroradiology, Boston University School of Medicine, Boston, 02493, Massachusetts, USA

    Rathan Subramaniam

  3. Dept. Radiology, Boston University Medical Center, E. Newton St. 88, Boston, 02118, Massachusetts, USA

    Ali Guermazi

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Subramaniam, R.M., Prompers, L., Agarwal, A., Guermazi, A., Mottaghy, F.M. (2012). Hematology. In: Peller, P., Subramaniam, R., Guermazi, A. (eds) PET-CT and PET-MRI in Oncology. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_594

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