Advanced Hodgkin’s lymphoma: End-of-treatment FDG-PET should be maintained

Positron emission tomography with ¹⁸F–fluorodeoxyglucose (FDG-PET) has become a cornerstone procedure in the modern management of Hodgkin’s lymphoma (HL) [1‐4]. It offers better initial staging and risk stratification [3]. FDG-PET often detects occult extranodal disease, notably focal bone marrow lesions [5‐7]. It rendered useless routine bone marrow biopsy [3]. HL is associated with a high rate of residual masses at the end of therapy, which are difficult to characterize as residual disease or not on conventional imaging. Therefore, a major milestone was the finding that end-of-treatment FDG-PET offers excellent prediction of progression-free-survival (PFS), even in the presence of a residual mass [8‐11]. This finding led to the introduction of FDG-PET imaging in response criteria for HL [12]. …