ABDOMINAL LYMPHOMA: IMAGING WORK UP CHALLENGES AND RECOMMENDATIONS IN RESOURCE LIMITED SETUP

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Accurate diagnosis and staging are fundamental for effective lymphoma management.
• Advances in cross-sectional and nuclear medicine imaging improve patient workup.
• Limited access to modern imaging and lack of standardized protocols pose challenges in resource-limited settings.

Purpose of the Study:

• To assess local lymphoma imaging workup and management challenges.
• To develop local imaging and reporting guidelines for lymphoma patients.
• To evaluate the role of various imaging modalities in resource-limited environments.

Main Methods:

• Qualitative study involving semi-structured interviews with six physicians (hematologists, oncologists, pathologists).
• Literature review on imaging modalities, recommendations, and international experiences.
• Analysis of current imaging practices in a resource-limited setting.

Main Results:

• Conventional and basic imaging modalities are currently employed.
• Computed tomography (CT) of the chest, abdomen, and pelvis is recommended for initial diagnosis.
• Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) or PET-CT is advised for follow-up and recurrence.
• Ultrasound (US) is the primary modality due to its availability and diagnostic potential.
• Inconsistent radiologist reports and lack of information challenge physicians.

Conclusions:

• Ultrasound (US) should remain the primary imaging modality for initial treatment, staging, and follow-up in resource-limited settings.
• A general imaging workup and reporting framework is recommended.
• Addressing challenges in imaging standardization and reporting is essential for improved lymphoma patient management.