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Role of Imaging in the Staging and Response Assessment of Lymphoma: Consensus of the International Conference on Malignant Lymphomas Imaging Working Group

Research output: Contribution to journalArticle

Sally F Barrington, N George Mikhaeel, Lale Kostakoglu, Michel Meignan, Martin Hutchings, Stefan P Müeller, Lawrence H Schwartz, Emanuele Zucca, Richard I Fisher, Judith Trotman, Otto S Hoekstra, Rodney J Hicks, Michael J O'Doherty, Roland Hustinx, Alberto Biggi, Bruce D Cheson

Original languageEnglish
Pages (from-to)3048-3058
Number of pages11
JournalJournal of clinical oncology : official journal of the American Society of Clinical Oncology
Issue number27
Early online date11 Aug 2014
Accepted/In press31 Mar 2014
E-pub ahead of print11 Aug 2014
Published20 Sep 2014

King's Authors


Purpose: Recent advances in imaging, use of prognostic indices, and molecular profiling techniques have the potential to improve disease characterization and outcomes in lymphoma. International trials are under way to test image-based response–adapted treatment guided by early interim positron emission tomography (PET) –computed tomography (CT). Progress in imaging is influencing trial design and affecting clinical practice. In particular, a five-point scale to grade response using PET-CT, which can be adapted to suit requirements for early- and late-response assessment with good interobserver agreement, is becoming widely used both in practice- and response-adapted trials. A workshop held at the 11th International Conference on Malignant Lymphomas (ICML) in 2011 concluded that revision to current staging and response criteria was timely.

Methods: An imaging working group composed of representatives from major international cooperative groups was asked to review the literature, share knowledge about research in progress, and identify key areas for research pertaining to imaging and lymphoma.

Results: A working paper was circulated for comment and presented at the Fourth International Workshop on PET in Lymphoma in Menton, France, and the 12th ICML in Lugano, Switzerland, to update the International Harmonisation Project guidance regarding PET. Recommendations were made to optimize the use of PET-CT in staging and response assessment of lymphoma, including qualitative and quantitative methods.

Conclusion: This article comprises the consensus reached to update guidance on the use of PET-CT for staging and response assessment for [18F]fluorodeoxyglucose-avid lymphomas in clinical practice and late-phase trials.

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