LYMPHOMA: A BRIEF REVIEW OF ROLE OF IMAGING IN STAGING AND FOLLOW UP
Dr. Zohaib Hussain* and Prof. Dr. Parul Dutta
ABSTRACT
Lymphoproliferative diseases are a group of cancers arising from B cells, T cells and natural killer cells (NK), which differ greatly in their nature, clinical path and therapeutic responses. Non-Hodgkin’s lymphoma (NHL) and Hodgkin’s lymphoma (HL) constitute the 5th most common malignancy in the west. However incidence in India is one-fourth of that in the western world. The Ann Arbor staging system was first developed in 1971 and updated by "Cotswolds modification" in 1989 and refers to both HL and NHL. Additionally, the Lugano classification (2014) and more recently the RECIL 2017 criteria, have been introduced to simplify and standardize staging and treatment outcome evaluations with primary emphasis on Computed Tomography (CT) and Positron emission tomography-computed tomography (PET-CT) evaluation. CT and PET-CT are being utilized as primary techniques for staging, and MRI being a complementary tool. 18-F- Fluorodeoxyglucose positron emission tomography-computed tomography (18-FDG PET-CT) for functional imaging has now replaced Gallium scans. Lymphoma management depends on its subtype and clinical stage. An attempt is made to provide a better understanding of the Lugano classification and RECIL 2017 criteria that would benefit the radiologist to correctly plan management and achieve desired results illustrated by multiple cases evaluated at the authors’ institute. Cure is the goal of managing Hodgkin’s lymphoma and aggressive NHLs, such as diffuse large B cell lymphoma or peripheral T-cell lymphoma. Imaging plays an indispensable role in achieving this goal.
Keywords: 1. Lymphoma, 2. Imaging, 3. Staging, 4. Response-Assessment, 5. Follow-up, 6. PET-CT
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