Positron Emission Tomography Molecular Imaging for Phenotyping and Management of Lymphoma

Xiaohui Zhang; Han Jiang; Shuang Wu; Jing Wang; Rui Zhou; Xuexin He; Shufang Qian; Shuilin Zhao; Hong Zhang; Ali Cahid Civelek; Mei Tian

doi:10.1007/s43657-021-00042-x

Positron Emission Tomography Molecular Imaging for Phenotyping and Management of Lymphoma

Phenomics. 2022 Feb 24;2(2):102-118. doi: 10.1007/s43657-021-00042-x. eCollection 2022 Apr.

Authors

Xiaohui Zhang^#^{1

2

3}, Han Jiang^#⁴, Shuang Wu^{1

2

3}, Jing Wang^{1

2

3}, Rui Zhou^{1

2

3}, Xuexin He⁵, Shufang Qian^{1

2

3}, Shuilin Zhao^{1

2

3}, Hong Zhang^{1

2

3

6

7}, Ali Cahid Civelek⁸, Mei Tian⁹

Affiliations

¹ Department of Nuclear Medicine and PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 Zhejiang China.
² Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, 310009 Zhejiang China.
³ Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, 310009 Zhejiang China.
⁴ PET-CT Center, Fujian Medical University Union Hospital, Fuzhou, 350001 Fujian China.
⁵ Department of Medical Oncology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, 310009 Zhejiang China.
⁶ Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, 310027 Zhejiang China.
⁷ College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, 310027 Zhejiang China.
⁸ Department of Radiology and Radiological Science, Johns Hopkins Medicine, Baltimore, MD 21287 USA.
⁹ Human Phenome Institute, Fudan University, Shanghai, 201203 China.

^# Contributed equally.

Abstract

Positron emission tomography (PET) represents molecular imaging for non-invasive phenotyping of physiological and biochemical processes in various oncological diseases. PET imaging with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) for glucose metabolism evaluation is the standard imaging modality for the clinical management of lymphoma. One of the ¹⁸F-FDG PET applications is the detection and pre-treatment staging of lymphoma, which is highly sensitive. ¹⁸F-FDG PET is also applied during treatment to evaluate the individual chemo-sensitivity and accordingly guide the response-adapted therapy. At the end of the therapy regiment, a negative PET scan is indicative of a good prognosis in patients with advanced Hodgkin's lymphoma and diffuse large B-cell lymphoma. Thus, adjuvant radiotherapy may be alleviated. Future PET studies using non-¹⁸F-FDG radiotracers, such as ⁶⁸Ga-labeled pentixafor (a cyclic pentapeptide that enables sensitive and high-contrast imaging of C-X-C motif chemokine receptor 4), ⁶⁸Ga-labeled fibroblast activation protein inhibitor (FAPI) that reflects the tumor microenvironment, and ⁸⁹Zr-labeled atezolizumab that targets the programmed cell death-ligand 1 (PD-L1), may complement ¹⁸F-FDG and offer essential tools to decode lymphoma phenotypes further and identify the mechanisms of lymphoma therapy.

Keywords: Glucose metabolism; Lymphoma; Positron emission tomography (PET); Response assessment; Staging.

Publication types

Review