PET/CT is a powerful and accurate tool for Hodgkin’s lymphoma and intermediate to high grade Non-Hodgkin’s lymphoma. It is not very effective for low-grade lymphomas.
PET/CT is not typically used to diagnose lymphoma. When it is used for diagnosis, it is most often used to guide biopsy.
PET/CT is the most powerful and accurate tool for staging, measuring response to therapy, restaging and surveillance. The evidence strongly supports having a PET/CT scan to answer each of these questions, and several PET/CT scans to detect recurrence after treatment is completed. After diagnosis, a patient might have as many as 6 PET/CT scans over the next two years.
For lymphoma, PET/CT excels in determining if chemotherapy is working. If there is an alternative chemotherapy or therapy in general, then PET/CT may be useful for deciding if you should switch therapies.
Patient: Thirty five year old patient with non-Hodgkin’s lymphoma. A PET/CT scan was ordered to stage the patient. After 3 cycles of R/CHOP, another PET/CT scan was done to determine if therapy was working. Notice how the staging scan also is necessary to provide a reference scan for the scan done after 3 cycles of therapy.
Results: The first PET scan showed that chemotherapy was the most appropriate therapy for this patient. The scan after three cycles of therapy showed that the disease was getting worse and suggested that an alternative therapy be used. Incidentally, the report from a CT-only scan on this patient after 3 cycles of therapy said that the patient was improving.
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