SynthesisThe British journal of radiology2025
18F-FDG PET or PET/CT in detecting high-grade transformation of chronic lymphocytic leukaemia and indolent lymphomas: a systematic review and meta-analysis.
Synthesis in The British journal of radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Canadian Hematology Consensus Group Recommendations for the Management of Relapsed and/or Refractory Follicular Lymphoma.Current oncology (Toronto, Ont.) · 2026Review
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Authors and funding
5 authors.
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Abstract
objectivesTo evaluate the diagnostic accuracy of 18F-FDG positron emission tomography (PET) or PET/computed tomography (CT) in detecting histological transformation (HT) of indolent lymphomas.
methodsA systematic search of articles up to July 2024 was performed in Embase and Medline. Eligible studies included adults with histologically proven indolent lymphoma, 18F-FDG PET or PET/CT as the index test, and sufficient data to assess diagnostic performance. Summary receiver operating characteristic curves were plotted using a bivariate model to estimate diagnostic accuracy with area under the curve (AUC).
resultsFifteen studies with 1307 participants were included. Ten studies assessed PET ability to detect Richter's transformation, and 5 studies focused on HT in follicular lymphoma and other subtypes. A meta-analysis of the former showed pooled sensitivity of 0.90 (95% CI, 0.84-0.93) and specificity of 0.54 (95% CI, 0.28-0.77) when using a maximum standardized uptake value (SUVmax) threshold of around 5. AUC was 0.89. Pooled sensitivity was 0.74 (95% CI, 0.54-0.87), and specificity was 0.84 (95% CI, 0.67-0.93) when using an SUVmax threshold of around 10. Area under the curve was 0.84. For detecting HT in follicular lymphoma, thresholds were found higher than those for Richter's transformation.
conclusions18F-FDG PET or PET/CT demonstrates good diagnostic accuracy to detect Richter's transformation, best when employing SUVmax ≥ 5. SUVmax thresholds may be limited in discriminating follicular lymphoma from HT, and alternatives should be sought. ADVANCES IN KNOWLEDGE: If biopsy is feasible, SUVmax ≥ 5 can guide biopsy in patients with clinically suspicious Richter's transformation. If biopsy is infeasible, SUVmax ≥ 10 can better identify HT and guide patient management.
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