Recommendation ID

Baseline FDG-PET-CT imaging for people with diffuse large B-cell lymphoma stage II or above:- In people with diffuse large B-cell lymphoma stage II or above, does a baseline FDG-PET-CT scan have any advantages over a baseline CT scan in the correct interpretation of the end-of-treatment FDG-PET-CT scan?

Any explanatory notes
(if applicable)

Why this is important:- A number of consensus-based guidelines and a body of clinical opinion advocate baseline FDG-PET-CT imaging as being important for interpreting end-of-treatment response using FDG-PET-CT, although there is little published evidence for this. Baseline FDG-PET-CT is also considered to have an important contribution 'over and above' that of contrast-enhanced diagnostic CT in assigning the International Prognostic Index (IPI), in terms of identifying disease stage and number of extranodal sites involved influencing the decision to offer central nervous system prophylaxis). A prospective trial is needed to determine whether baseline FDG-PET-CT is needed to interpret end-of-treatment FDG-PET-CT and its role in assigning IPI. People with newly histologically diagnosed diffuse large B-cell lymphoma would have baseline contrast-enhanced CT, baseline FDG-PET-CT and end-of-treatment FDG-PET-CT imaging. Readers would need to be trained in both imaging techniques and be experienced members of lymphoma multidisciplinary teams. The reference standard would be histological confirmation of any positive or equivocal
end-of-treatment FDG-PET-CT findings, or follow-up if there is a negative end-of-treatment scan.

Source guidance details

Comes from guidance
Non-Hodgkin’s lymphoma: diagnosis and management
Date issued
July 2016

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/07/2016