Pediatric lymphomas represent one of the most common malignancies in children and adolescents, comprising Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), two entities with distinct biological and clinical features. Over recent decades, survival rates have markedly improved due to risk-adapted chemotherapy protocols and optimized supportive care, shifting the clinical focus toward minimizing long-term treatment-related toxicity. In this context, [18F]FDG-PET/CT has become a cornerstone imaging modality in pediatric lymphoma management, for its ability to accurately detect nodal and extranodal disease, improving staging accuracy, informing risk-adapted therapy, and supporting efforts to balance treatment efficacy with long-term safety. In this chapter, the current status of [18F]FDG-PET in pediatric lymphoma is presented in detail with regard to P-HL and P-NHL. The core elements are the sections on staging and response assessment. In addition, challenges and pitfalls are discussed. In the future, innovations in low-dose ultrafast total-body PET/CT, the increasing use of PET/MR, and the integration of quantitative parameters like total metabolic tumor volume (TMTV) from PET will enable more precise prediction of response and personalized therapy, while minimizing radiation exposure and treatment-related adverse effects.

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Pediatric Population

  • Cristina Ferrari,
  • Giuseppe Rubini

摘要

Pediatric lymphomas represent one of the most common malignancies in children and adolescents, comprising Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL), two entities with distinct biological and clinical features. Over recent decades, survival rates have markedly improved due to risk-adapted chemotherapy protocols and optimized supportive care, shifting the clinical focus toward minimizing long-term treatment-related toxicity. In this context, [18F]FDG-PET/CT has become a cornerstone imaging modality in pediatric lymphoma management, for its ability to accurately detect nodal and extranodal disease, improving staging accuracy, informing risk-adapted therapy, and supporting efforts to balance treatment efficacy with long-term safety. In this chapter, the current status of [18F]FDG-PET in pediatric lymphoma is presented in detail with regard to P-HL and P-NHL. The core elements are the sections on staging and response assessment. In addition, challenges and pitfalls are discussed. In the future, innovations in low-dose ultrafast total-body PET/CT, the increasing use of PET/MR, and the integration of quantitative parameters like total metabolic tumor volume (TMTV) from PET will enable more precise prediction of response and personalized therapy, while minimizing radiation exposure and treatment-related adverse effects.