PET/CT DISADVANTAGES IN PATIENTS WITH LYMPHOMA: А LITERATURE REVIEW

Abstract

Relevance: Positron emission tomography combined with computed tomography (PET/CT) is a young and promising technique for lymphoproliferative diseases’ primary detection, staging, and evaluation of the treatment results. However, at this stage of nuclear medicine development, some shortcomings in PET/CT diagnostics of lymphomas using 18Fluorodeoxyglucose (F18-FDG) affect its reliability to a certain extent. The study aimed to evaluate the physical and technical weaknesses of F18-FDG PET/CT in diagnosing lymphomas and review the analytical methods that affect opinion accuracy. Methods: The articles on the use of F18-FDG PET/CT in diagnosing lymphomas, its reliability, and methods for optimizing were searched in the PUBMED database for 2012-2022. Results: One of the main shortcomings of F18-FDG PET/CT in diagnosing lymphomas is the Deauville 5-point scale, which does not fully meet clinical requirements. This scale has some disadvantages, including low inter-reader agreement and an unreliable reference organ for F18-FDG accumulation. Mathematical algorithms for correction to the patient’s weight also require optimization. Conclusion: Some of the existing deficiencies can be improved at the software level and through educating staff about the importance of changing the SUV calculation method. However, other deficiencies, such as classifications that do not meet clinical requirements, require more efforts at the level of international experts and much more in-depth study of this issue to avoid such shortcomings of new staging methods. However, even considering all the shortcomings described, at the moment, PET/CT with F18-FDG is one of the most reliable modalities available, both for the initial detection and for evaluating the therapy effectiveness in patients with lymphomas.