TEP/TDM au FDG et bilan initial des lymphomes : du diagnostic au pronostic

Lymphoma represents a very heterogeneous pathologic disease group and its initial assessment, treatment strategy and prognosis is closely related within each histological subtype. The diagnosis of lymphoma disease is often due to the development of a tumour mass at a lymph node area, or within an organ with or without systemic symptoms. However, all these signs remain non specific. Biopsy is the only reliable diagnostic tool, which can be carried out surgically or guided by the morphological and functional imaging. Once the histological diagnosis is determined by the WHO classification, the staging procedure aim is to provide the prognosis to assist the therapeutic decision. Morphologic imaging primarily based on CT remains the reference in exploring most cases. But in the last decade, the introduction of functional imaging using FDG-PET/CT has dramatically changed the therapeutic management of lymphoma. The additional clinical value provided by initial FDG-PET/CT could lead to an alteration of the therapeutic strategy, as well as to the optimization of radiation therapy or to the establishment of prognostic score and lead to improved lymphoma patient survival in the future.