The role of positron emission tomography in different types of malignant lymphomas: the results of 2020

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Abstract

The review presents the results of studies published in 2020 concerning the role of positron emission tomography (PET) in the diagnosis of different types of malignant lymphomas. The authors tried to highlight the current trends in the development of the PET method in case of Hodgkin lymphoma, diffuse large B-cell lymphoma, follicular lymphoma and multiple myeloma. The topic concerning the use of PET in immunotherapy is highlighted separately. There was also an emphasis on the interpretation of quantitative imaging biomarkers used in PET. The concept of PET-adapted approach in Hodgkin lymphoma, the predictive significance of PET before high-dose chemotherapy and autologous hematopoietic stem cell transplantation in patients with diffuse large B-cell lymphoma, predictive value of intermediate PET in case of follicular lymphoma, the application of methionine as PET tracer to diagnose tumor burden and to measure minimal residual disease in case of multiple myeloma, the variants of atypical tumor response to the immune checkpoint inhibitors therapy, PET in diagnosing immune-mediated adverse events are currently relevant for oncologists, hematologists, radiologists and discussed in this article. In the context of the topics the authors showed the results of PET imaging of Russian patients who had PET examination in the Bakulev National Medical Research Center for Cardiovascular Surgery.

About the authors

Vladislav O. Sarzhevskiy

Pirogov National Medical and Surgical Center

Author for correspondence.
Email: vladsar100@gmail.com
ORCID iD: 0000-0001-7164-6595

D. Sci. (Med.)

Russian Federation, Moscow

Olga V. Mukhortova

Bakulev National Medical Research Center for Cardiovascular Surgery

Email: vladsar100@gmail.com
ORCID iD: 0000-0002-7716-5896

D. Sci. (Med.)

Russian Federation, Moscow

References

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Supplementary files

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2. Fig. 1. The design of the GHSG HD17 protocol (F. Michael et al. ASH 2020) [2].

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3. Fig. 2. The data of 5-year progression-free survival (PFS) in the groups of standard and PET-adapted approach examination (the GHSG HD17 protocol).

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4. Fig. 3. The data of 5-year PFS, depending on the degree of 18F-FLT accumulation according to the Deauville scale (the GHSG HD17 protocol).

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5. Fig. 4. The design of the AHL study 2011.

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6. Fig. 5. The data of 5-year PFS in the groups of standard and PET-adapted approach examination (AHL 2011 study).

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7. Fig. 6 The data of 5-year PFS depending on the results of PET-CT after 4 cycles of chemotherapy (AHL 2011 study).

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8. Fig. 7. Survival data in patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) depending on the results of PET-CT before the application of «rescue» therapy (MTV measurement).

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9. Fig. 8. The data of PFS in patients with R/R DLBCL, depending on the results of PET-CT examination on the 4th and 21st days of the first cycle of platinum-containing therapy «rescue therapy».

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10. Fig. 9. The data of PFS in patients with R/R DLBCL, depending on the results of PET-CT before the CAR T infusion.

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11. Fig. 10. The data of PFS in patients with follicular lymphoma (FL) depending on the results of the intermediate PET-CT.

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12. Fig. 11: a – the data of OS in patients with high SUVmax in case of FL – the application of R-CHOP and BR therapy; b – the data of PFS in patients with high SUVmax in case of FL – the application of supporting R therapy or without it.

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13. Fig. 12. Patient with multiple myeloma (MM), who during the first day had 2 PET-CT examinations with various drugs – 11C-MET (left) and 18F-FLT (right) [from the archives of the Bakulev National Medical Research Center for Cardiovascular Surgery].

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14. Fig. 13. Survival data in patients with MM, depending on the achievement of the complete metabolic response assessed according to the Deauville scale.

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15. Fig. 14. Patient with MM after auto-HSCT; PET-CT with 11C-MET (left) and 18F-FLT (right); PET with 11C-MET clearly detected 2 focuses of pathological activity in the pelvis (from the archives of the Bakulev National Medical Research Center for Cardiovascular Surgery).

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16. Fig. 15. Pseudoprogression during immunotherapy.

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17. Fig. 16. Local pseudoprogression during immunotherapy.

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18. Fig. 17. Hyperprogression during immunotherapy.

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19. Fig. 18. Patient with Hodgkin lymphoma (HL). Pulmonitis after PD-1 inhibitor therapy. The residual mediastinal mass was PET-negative (from the archives of the Bakulev National Medical Research Center for Cardiovascular Surgery).

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20. Fig. 19. Patient with HL. The appearance of symmetrical changes in the adrenal glands against the background of the complete metabolic response of the tumor during PD-1 inhibitor therapy. PET-CT data in 6 and 10 months after the beginning of the treatment (increased changes in the adrenal glands) [from the archives of the Bakulev National Medical Research Center for Cardiovascular Surgery].

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Copyright (c) 2021 Consilium Medicum

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