Bildgebende Diagnostik von malignen Lymphomen

BACKROUND: Malignant lymphomas represent approximately 5% of all cancers. Imaging procedures play a crucial role concerning initial staging and assessment of the response to treatment. OBJECTIVE: This article gives an overview of the significance of imaging procedures in the treatment of patients with malignant lymphomas at various times during treatment. These include the initial assessment of the extent of the disease and staging during and after treatment under consideration of the current classification systems. MATERIAL AND METHODS: A selective literature search was carried out with analysis of dedicated original research articles and reviews as well as a discussion of the clinical guidelines. RESULTS: Computed tomography (CT) is the basic diagnostic tool in patients with malignant lymphomas. Particularly important is fluorodeoxyglucose (FDG) positron emission tomography (PET) CT, which enables a more accurate stage definition and a better assessment of the response to treatment in FDG-avid lymphoma subtypes. Using the FDG-PET/CT-based Deauville score persisting disease activity can be identified in residual masses and refractory disease can be distinguished from complete metabolic remission. The use of magnetic resonance imaging (MRI) with diffusion-weighted imaging can represent a future alternative but is, however, not yet sufficiently standardized and validated. CONCLUSION: The standardized analysis and reporting of purely morphological and metabolic imaging procedures is the backbone of treatment decisions in patients with malignant lymphomas.