Lymphoma Follow-Up Imaging Guidelines

Post-Treatment Response Assessment

• A CT scan of all initially involved areas is mandatory to confirm complete remission at the end of treatment, according to the Haematologica guidelines 1
• For FDG-avid lymphomas, PET-CT is the gold standard for end-of-treatment response assessment, as recommended by the Journal of Clinical Oncology guidelines 2

Surveillance Imaging Schedule

• Chest X-ray or CT scan every 6-12 months during the first 2-5 years is suggested for patients at higher risk of relapse, as per the Haematologica guidelines 1
• Physical examination and laboratory tests should be performed every 3 months for the first year, every 6 months in years 2-3, then annually thereafter, according to the Haematologica guidelines 1

Clinical Detection vs. Imaging Surveillance

• Physical examination detecting new or enlarging lymphadenopathy identifies most recurrences, as stated in the Haematologica guidelines 1
• Elevated LDH often accompanies relapse, as noted in the Praxis Medical Insights guidelines 3
• B symptoms, such as fever, night sweats, and weight loss, are present in many relapses, according to the Praxis Medical Insights guidelines 3

Special Populations

• Patients with high-risk features at diagnosis, such as IPI ≥4, may require closer imaging surveillance, as recommended by the Haematologica guidelines 1
• Women who received chest radiation should undergo annual mammography starting at age 40 for breast cancer screening, according to the Haematologica guidelines 1