Application of the Lugano Classification for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The PRoLoG Consensus Initiative (Part 2-Technical).

in Journal of nuclear medicine : official publication, Society of Nuclear Medicine by Fabien Ricard, Sally Barrington, Ron Korn, Guenther Brueggenwerth, Judith Trotman, Bruce Cheson, Gilles Salles, Larry Schwartz, Greg Goldmacher, Rudresh Jarecha, Jayant Narang, Florence Broussais, Paul Galette, Min Liu, Surabhi Bajpai, Eric Perlman, Julie Gillis, Ira Smalberg, Pierre Terve, Gudrun Zahlmann, Annette Schmid

TLDR

  • The study provides consensus recommendations for the consistent application of imaging assessment with the Lugano classification, covering technical imaging aspects and aimed at addressing inconsistencies and ambiguities

Abstract

The aim of this initiative was to provide consensus recommendations from a consortium of academic and industry experts in the field of lymphoma and imaging for the consistent application of imaging assessment with the Lugano classification.Consensus was obtained through a series of meetings from July 2019 to October 2021 sponsored by the PINTaD (Pharma Imaging Network for Therapeutics and Diagnostics) as part of the ProLoG (INTaDespnse criteria inymphoma wrkingroup) consensus initiative.Consensus recommendations encompass all technical imaging aspects of the Lugano classification. Some technical considerations for PET/CT and diagnostic CT are clarified with regards to required imaging series and scan visits, as well as acquisition and reconstruction of PET images and influence of lesion size and background activity. Recommendations are given on the role of imaging and clinical reviewers as well as on training and monitoring. Finally, an example template of an imaging case report form is provided to support efficient collection of data with Lugano Classification.Consensus recommendations are made to comprehensively address technical and imaging areas of inconsistency and ambiguity in the classification encountered by end users. Such guidance should be used to support standardized acquisition and evaluation with the Lugano 2014.

Overview

  • The study aimed to provide consensus recommendations for the consistent application of imaging assessment with the Lugano classification, sponsored by PINTaD and ProLoG
  • A series of meetings took place between July 2019 and October 2021 involving academic and industry experts in lymphoma and imaging
  • The consensus recommendations cover all technical imaging aspects of the Lugano classification, focusing on PET/CT and diagnostic CT

Comparative Analysis & Findings

  • The study provides clear guidelines on required imaging series and scan visits for PET/CT and diagnostic CT, as well as image acquisition and reconstruction
  • Recommendations are given on the role of imaging and clinical reviewers, and on training and monitoring to ensure standardized imaging assessment
  • An example template is provided for imaging case report forms to support efficient data collection and Lugano classification

Implications and Future Directions

  • The consensus recommendations aim to address technical and imaging inconsistencies and ambiguities in the Lugano classification, providing a standardized approach for end users
  • The guidance is essential for supporting standardized acquisition and evaluation with the Lugano 2014 classification
  • Future research can focus on refining the consensus recommendations and addressing any limitations or areas of uncertainty
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