RESPONSE EVALUATION IN LYMPPHOMA

1. Response assessment
lymphomas

2. Introduction
• International working group response criteria bby cheson et al
(JCO,1999)
• Guidelines for response assessment and outcome measurement
• Limitations :
• Inter and intra observer variation
• Cru (misinterpretetion)
• No inclusion of extranodal disease
• Increased use of PET, IHC, flow cytometrey

3. International harmonization project
• Modification of the IWG by german competence network malignant
lymphoma

4. • At the time, PET was recommended for posttreatment
assessment of DLBCL and HL,( but only in clinical trials for
follicular lymphoma or other fluorodeoxyglucose (FDG) avid
histologies).
• Further experience with the interpretation of PET scan results
subsequently led to the Lugano Classification for staging and
response assessment,
• incorporating PET-CT as a standard component of both the
staging and response assessment of FDG-avid histologies
while retaining CT evaluation for other subtypes.

6. • FIRST PROJECT DEVOTED TO LYMPHOMA CLASSIFICATION IN 1971 BY
ANN ARBOR
• FIRST MODIFICATION BY COSTWOLDS AFTYER CT INTRO

15. RECOMMENDATIONS
• USE PET CT FOR FDG AVID LYMPHOMAS BASED ON D.S USING 5 PS
SCALE
• SOC FOR ASSESSMENT OF HL, DLBCL, HIGH TUMOR BURDEN FL
• IF MID THERAPY IMAGING IS PERFORMED, PET CT IS SUP TO CT
ALONE
• NO CONCLUSIVE EVIDENCE TO CHANGE RX BASED ON SOLELY PET CT
UNLESS THERE IS CLEAR ANND CLINICAL, HISTOOGICAL PROGRESSION
CONFIRMATOIN