However, several pitfalls may occur during or after treatment, because of the nonspecificity of F-FDG for lymphoma disease and treatment as immunotherapy, thus possibly induces misinterpretation and wrong treatment decision.
The metabolic behavior of this lymphoma is not still clear because only a few case reports are present in literature describing the possible role of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in this field.
The 18F-FDG positron-emission tomography (PET) and contrast-enhanced computerised tomography (CECT) data of all relapsed or refractory HL treated at Gustave Roussy, Villejuif, France, from 2013 to 2015 were retrospectively reviewed according to the International Harmonisation Project Cheson 2014 criteria and the LYmphoma Response to Immunomodulatory therapy Criteria (LYRIC).
F-FDG PET/CT showed hypermetabolic foci in the liver, spleen, and bone marrow, as well as multiple FDG-avid lymph nodes, which were highly suggestive of lymphoma.
FDG PET/CT has optimum negative predictive value compared with BMB in detection of bone marrow infiltrations in pediatric lymphoma with upstaging cases missed with BMB.
Since the introduction of FDG-PET for the staging and restaging of patients with lymphoma, a high predictive value of F-18-FDG-PET in response assessment has been observed.
Two types of metabolic behavior were therefore identified using F-choline and F-FDG which corresponded to 2 different uptake patterns, that is, those of the prostate and lymphoma tumoral cell contingents.
Varying patterns of FDG uptake was observed across various lymphoma entities; hence, interpretation of FDG-PET scans should be in the context of the tumor architecture and the prevalence of cellular population, in particular, neoplastic vs non-neoplastic inflammatory cells present in tissue microenvironment.
Although positron emission tomography with 18F-fluoro-2-deoxyglucose (FDG-PET/CT) has been recommended as the method of choice for lymphoma staging, it has limited availability in several countries, therefore, studies comparing whole-body magnetic resonance imaging (MRI) to conventional staging methods or to FDG-PET/CT are an important tool to establish whole-body MRI as an alternative to these methods.
Predictions of outcome after first-line treatment for DLBCL were surprisingly good when left to the unsupervised, subjective judgment of experienced readers of lymphoma 18F-FDG-PET/CT.
Interim and posttreatment sequential FDG PET/CT scans revealed a residual splenic mass showing markedly intense FDG uptake suspected of a residual viable lymphoma.
Although <sup>18</sup>F-FDG has proved useful in the management of patients with lymphoma, the specificity of <sup>18</sup>F-FDG uptake has been critically questioned, and is not without flaws.
The impact of early fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET-CT) status on survival after allogeneic transplantation for lymphoma is poorly reported.
Burkitt's lymphoma is a lymphoma with unclear metabolic behavior at 18F-FDG-PET/CT and no validated criteria in treatment evaluation and prediction of outcome exist.