[Hemato-oncological imaging : Importance of hybrid procedures]

Abstract

Clinical/methodical issue: Biomedical imaging procedures play a major role in hemato-oncological diseases with respect to pre-therapeutic staging and assessment of treatment response.

Standard radiological methods: Originally, the therapeutic management was the domain of computed tomography (CT) and whole-body magnetic resonance imaging (MRI).

Methodical innovations: Over the last decade these purely morphological techniques have gradually been replaced by hybrid imaging techniques, such as positron emission tomography-CT (PET/CT) and PET/MRI, which also provide metabolic and functional information.

Performance: For lymphomas, the PET tracer 18F-fluorodeoxyglucose (18 F-FDG) is meanwhile so well-established that its use is a cornerstone of the Lugano classification; however, for multiple myeloma the search for an optimal PET tracer that can also detect early disease stages is still ongoing. Functional MRI techniques, such as diffusion-weighted imaging (DWI), perfusion-weighted imaging and dynamic contrast-enhanced imaging have shown promising results for both lymphomas and multiple myelomas.

Achievements: The PET/MRI technique can combine the different types of information due to its truly multiparametric approach.

Practical recommendations: In the future PET/MRI could possibly become the hybrid imaging technique of choice for hemato-oncological diseases.

Keywords: 18F Fluorodeoxyglucose; Multiparametric approach; Positron emission tomography; Staging; Therapy response.