Surveillance scanning in lymphoma

Although the role of imaging in the management of most lymphomas is well established at baseline, during treatment, and following treatment, surveillance imaging after complete response remains controversial despite the numerous studies that have investigated follow-up computed tomography, positron emission tomography, and magnetic resonance imaging over the past 20 years. Although robust data do not support an impact of this strategy on survival in Hodgkin lymphoma, diffuse large B-cell lymphoma, or follicular lymphoma, many patients continue to undergo serial imaging studies. The role of imaging following treatment in peripheral T-cell lymphoma (PTCL) and mantle cell lymphoma (MCL) is poorly investigated, although the available literature questions the utility of scanning patients with PTCL or MCL in first remission. Of clear significance in all lymphoma subtypes is the effect of such imaging on patient anxiety, secondary cancers, and health care costs. Novel monitoring strategies, such as minimal residual disease detection with circulating tumor DNA, are being examined in lymphoma and may provide a more accurate method by which to survey patients. Here I review the current literature on follow-up imaging in lymphoma patients by subtype.