“REVISEDRESPONSECRITERIAFORMALIGNANTLYMPHOMA”JClinOncol25:579-586.©2007byAmericanSocietyofClinicalOncologyChesonetal,JClinOncol17:1244,1999In1999,anInternationalWorkingGroup(IWG)ofclinicians,radiologists,andpathologistswithexpertiseintheevaluationandmanagementofpatientswithLymphomapublishedguidelinesforresponseassessmentandoutcomesmeasurement.ResponseCriteriaforLymphomaReappearanceNeworincreasedNeworincreasedEnlargingliver/spleen;newsitesRelapse/progressionIrrelevant≥50%decrease≥50%decreaseDecreaseinliver/spleenIrrelevant≥50%decrease≥50%decreaseNormalPositiveNormalNormalNormalPRNormalorindeterminate>75%decreaseNormalNormalIndeterminateNormalNormalNormalCRuNormalNormalNormalNormalCRBoneMarrowLymphNodeMassesLymphNodesPhysicalExaminationResponseCategoryDefinitionsofEndPointsforClinicalTrialsDeathDeathrelatedtoNHLAllpatientsCause-specificdeathEntryontotrialTimewhennewtreatmentisneededAllpatientsTimetonexttreatmentFirstdocumentationofresponseTimetorelapseorprogressionCR,CRu,PRResponsedurationFirstdocumentationofresponseTimetorelapseCR,CRuDisease-freesurvivalEntryontotrialDiseaseprogressionordeathfromNHLAllpatientsProgression-freesurvivalEntryontotrialFailureordeathfromanycauseCR,CRu,PREvent-freesurvivalEntryontotrialDeathfromanycauseAllpatientsOverallsurvivalPointofMeasurementDefinitionResponseCategoryEndPointStandardizedresponsecriteriaprovideuniformendpointsforclinicaltrials:•Allowingforcomparisonsamongstudies•FacilitatingtheidentificationofmoreeffectivetherapiesThewidelyusedIWGcriteriaforresponseassessmentoflymphomaarebasedpredominantlyonCT.ItbecameclearthattheInternationalWorkingGroupcriteriawarrantedrevision,becauseofidentifiedlimitationsandtheincreaseduseof:1.[18F]fluorodeoxyglucose-positronemissiontomography(PET),2.immunohistochemistry(IHC),3.flowcytometry,4.molecularbiology“REVISEDRESPONSECRITERIAFORMALIGNANTLYMPHOMA”JClinOncol25:579-586.©2007byAmericanSocietyofClinicalOncologyTheCompetenceNetworkMalignantLymphomaconvenedanInternationalHarmonizationProjectatwhich5subcommitteeswereformed:•ResponseCriteria•EndPointsforClinicalTrials•Imaging•ClinicalFeatures•Pathology/BiologyUseofPositronEmissionTomographyforResponseAssessmentofLymphoma:ConsensusoftheImagingSubcommitteeofInternationalHarmonizationProjectinLymphomaJClinOncol25:571-578.©2007byAmericanSocietyofClinicalOncologyPET-PET/CT•PETusing[18F]fluorodeoxyglucose(FDG,aradioactivederivativeofglucose,isanadvancedimagingtool,basedontheincreasedglucoseconsumptionofcancercells),hasemergedasapowerfulfunctionalimagingtoolforstaging,restaging,andresponseassessmentoflymphomas.•TheadvantageofPEToverconventionalimagingtechniques,suchasTCorRMN,isitsabilitytodistinguishbetweenviabletumorandnecrosisorfibrosisinresidualmass(es)oftenpresentaftertreatment.ArecentlydevelopedintegratedPET/CTsystem,whichcombinesaPETcameraandCTscannerinasinglesession,hasovercomethesedrawbacksbyprovidingbothanatomicalandfunctionalimagingatthesameposition.PET/CThasbecomethenewstandardapproachtoimaginginthediagnosisandmanagementofmanycancerpatients.StandardizationofPETandCTImagingParametersPatientsundergoingPETimagingshouldreceiveanFDGdoseof3.5to8MBq/kgofbodyweight,withaminimumdoseof185MBqinadults(5mCi)and18.5MBq(0.5mCi)inchildren.Patientsshouldhavefastedforatleast4hoursbeforeFDGinjection.Bloodglucoselevelshouldnotexceed200mg/dLatthetimeo...
