Current status of the role of PET imaging in diffuse large B-cell lymphoma

PET-CT (positron emission tomography-computed tomography) has emerged as an indispensable tool in the management of patients with diffuse large B-cell lymphoma (DLBCL). It is the standard imaging test for initial staging and is superior to CT in determining remission status and has replaced CT in this regard. The focus of this seminar will highlight controversial aspects on the role of PET-CT in the treatment of patients with DLBCL and will address the following questions: 1) Is a contrasted enhanced CT scan necessary for initial staging in the PET era? 2) Is a bone marrow biopsy required for initial staging of DLBCL in the era of PET imaging? 3) What is the role of interim PET in management? 4) Should PET scans be used for surveillance in patients in remission? 5) What is the role of semiquantitative PET and CT metrics in prognostication and response assessment?