Staging and Response Assessment in Lymphoma:
Dr. Richard Tsang
FDG-PET is widely available and funded in Ontario for staging of limited stage lymphomas (since 2013), and for response assessment (since 2008). There are now updated criteria for evaluation, staging, and response assessment of patients with HL and NHL, incorporating PET-CT information, as provided by the Lugano Classification (2014).[i]
PET-CT is often helpful but not perfect. There can be false positives (inflammatory changes) and negatives (cannot detect microscopic disease). Additionally, PET-CT is sensitive for BM involvement. BM biopsy is not routinely required for HL, but may still be required for selective cases of NHL. A selective approach is likely the best course of action.