Surveillance imaging in pediatric lymphoma
Stephan D Voss1, Mitchell S Cairo2
1Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave., Boston, MA, 02115, USA. stephan.voss@childrens.harvard.edu.
Pediatric Radiology
|October 18, 2019
Summary
Routine surveillance imaging after treatment for childhood lymphomas may be reduced. A new risk-adapted strategy can identify children who benefit most from continued imaging, minimizing radiation exposure and costs.
Area of Science:
- Pediatric Oncology
- Radiology
- Hematology
Background:
- Current therapies for childhood Hodgkin lymphoma and non-Hodgkin lymphoma achieve high survival rates (>90%).
- Concerns exist regarding the cost, radiation exposure, and false-positive results associated with routine off-therapy surveillance imaging.
- Radiologic imaging is crucial for diagnosis and assessing treatment response.
Purpose of the Study:
- To review evidence supporting reduced off-therapy surveillance imaging in pediatric lymphoma survivors.
- To propose a novel risk-adapted and response-based surveillance imaging strategy.
- To optimize imaging use while maintaining patient safety and outcomes.
Main Methods:
- Review of recent studies on surveillance imaging in pediatric Hodgkin and non-Hodgkin lymphoma.
- Analysis of evidence regarding the efficacy and necessity of routine imaging.
- Development of a risk-adapted and response-based imaging strategy.
Main Results:
- Evidence suggests opportunities to significantly decrease off-therapy imaging evaluations in pediatric lymphoma survivors.
- A risk-adapted and response-based approach can guide decisions on which children require continued surveillance imaging.
- Reduced imaging can mitigate concerns about cost, radiation, and false positives.
Conclusions:
- Routine off-therapy surveillance imaging in pediatric lymphoma survivors can be selectively reduced.
- A novel risk-adapted and response-based strategy offers a framework for optimizing surveillance.
- This approach aims to balance effective monitoring with minimizing potential harms of imaging.
