FDG PET/CT Imaging in Hematological Oncology
Summary
Fluorodeoxyglucose (FDG) positron emission tomography combined with computed tomography (PET/CT) has become indispensable in the management of haematological malignancies. By visualising and quantifying glucose metabolism, FDG PET/CT informs staging, guides biopsy, assesses response to chemotherapy and radiotherapy, and provides prognostic biomarkers. In lymphomas, patterns of nodal and extranodal uptake define treatment strategy and predict early response. In diseases with bone marrow involvement—such as leukaemia, myeloma and certain lymphomas—markedly increased FDG uptake can signal malignant infiltration and influence decisions on marrow-directed therapy. Quantitative indices—standardised uptake values, volumetric measures of metabolic tumour volume and metrics comparing marrow or splenic uptake with that of normal liver tissue—enable more nuanced risk stratification. Although highly sensitive, FDG signals may be confounded by infection or inflammation; integration with clinical parameters and emerging hybrid techniques, including PET/MRI and artificial-intelligence-driven image analysis, promise further refinement of diagnostic accuracy and personalised patient management.
Research from Nature Portfolio
Recent studies have demonstrated that healthy tissue metabolism measured on interim FDG PET/CT scans in advanced Hodgkin lymphoma carries independent prognostic value. By evaluating FDG uptake in bone marrow, spleen, liver and blood pool before and after initial chemotherapy cycles, investigators showed that higher baseline marrow activity correlates with adverse haematological parameters and lower rates of early metabolic response. Patients with persistently elevated bone marrow uptake following two cycles exhibited a significantly shorter progression-free survival, indicating that quantitative assessment of normal tissue metabolism may guide adaptive treatment intensification.
FDG PET/CT Imaging in Hematological Oncology publication trend
The graph below shows the total number of articles in fdg pet/ct imaging in hematological oncology across all publications each year (not limited to Nature Index journals).
Technical terms
2-deoxy-2-[18F]fluoro-D-glucose (FDG): A radiolabelled glucose analogue used to visualise tissue metabolism in PET imaging.
Positron Emission Tomography/Computed Tomography (PET/CT): A hybrid imaging modality combining metabolic information from PET with anatomical detail from CT.
Standardised Uptake Value (SUV): A semiquantitative measure of radiotracer concentration in tissue, normalised for injected dose and patient body weight.
Metabolic Tumour Volume (MTV): The volume of tumour tissue demonstrating elevated FDG uptake above a defined threshold.
Bone Marrow-to-Liver Uptake Ratio (BLR): The ratio of mean FDG uptake in the bone marrow to that in normal liver tissue, used to assess marrow activity.
Progression-Free Survival (PFS): The period during which a patient remains free from disease progression or relapse following treatment.
References
- Healthy tissue metabolism assessed by [18F]FDG PET/CT as a marker of prognosis and adverse events in advanced Hodgkin lymphoma patients. Scientific Reports (2024).
- Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia. European Journal of Nuclear Medicine and Molecular Imaging (2020).
- Assessment of diffuse bone marrow involvement on 18F-fluoro-D-glucose PET/computed tomography. Clinical and Translational Imaging (2024).
- Integrated [18F]FDG PET/MRI demonstrates the iron-related bone-marrow physiology. Scientific Reports (2020).
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