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  Indian J Med Microbiol
 

Figure 7: Transaxial image, (a) of a patient with diffuse large B cell lymphoma (DLBCL) shows intensely fluoro-deoxy-glucose (FDG) avid (maximum standardized uptake value [SUVmax = 16.2]) presacral lymph nodal mass, which is significantly higher than liver uptake (London criteria score of 5), (b) Transaxial images of FDG positron emission tomography/computed tomography (PET/CT) of the same patient after two cycles of chemotherapy shows mild FDG uptake in the lymph nodal mass (SUVmax of 2.1), which is slightly higher than mediastinal uptake and less than liver (London criteria score of 2). Transaxial PET/CT images (c) of the same patient after four cycles of chemotherapy show FDG uptake equal to background tissues (London criteria score of 1). Maximum intensity projection (MIP) image (d) of a patient with DLBCL involving D4, D5 vertebrae and left 4th rib in staging PET/CT. MIP image, (e) of the same patient showing mild FDG uptake above background but equal to liver (London criteria score of 3) in the previously involved site. MIP image of staging PET/CT (f) of a patient with DLBCL showing intensely F-18 FDG avid disease in liver, spleen and abdominal, mediastinal and cervical lymph nodes. MIP image (g) of the same patient after four cycles of chemotherapy shows moderate FDG avidity above the liver in a retroperitoneal lymph node (London criteria score of 4) and the patient presented with progressive disease (H) after 3 months of chemotherapy. London criteria have been proposed for interpretation of interim FDG PET/CT to achieve inter-center reproducibilities.[10] According to London criteria FDG uptake of tumor is scored according to relative uptake to surrounding background, mediastinum and liver with scores ranging from 1 to 5. Early studies indicate that scores of 4 and 5 in interim PET/CT studies are associated with progression and non-achievement of complete response in patients with high-grade non-Hodgkin's Lymphoma and Hodgkin's Lymphoma respectively.[11,12] This image illustrates various scores for interpretation of interim F-18 FDG PET/CT according to London criteria

Figure 7: Transaxial image, (a) of a patient with diffuse large B cell lymphoma (DLBCL) shows intensely fluoro-deoxy-glucose (FDG) avid (maximum standardized uptake value [SUV<sub>max</sub> = 16.2]) presacral lymph nodal mass, which is significantly higher than liver uptake (London criteria score of 5), (b) Transaxial images of FDG positron emission tomography/computed tomography (PET/CT) of the same patient after two cycles of chemotherapy shows mild FDG uptake in the lymph nodal mass (SUV<sub>max</sub> of 2.1), which is slightly higher than mediastinal uptake and less than liver (London criteria score of 2). Transaxial PET/CT images (c) of the same patient after four cycles of chemotherapy show FDG uptake equal to background tissues (London criteria score of 1). Maximum intensity projection (MIP) image (d) of a patient with DLBCL involving D4, D5 vertebrae and left 4<sup>th</sup> rib in staging PET/CT. MIP image, (e) of the same patient showing mild FDG uptake above background but equal to liver (London criteria score of 3) in the previously involved site. MIP image of staging PET/CT (f) of a patient with DLBCL showing intensely F-18 FDG avid disease in liver, spleen and abdominal, mediastinal and cervical lymph nodes. MIP image (g) of the same patient after four cycles of chemotherapy shows moderate FDG avidity above the liver in a retroperitoneal lymph node (London criteria score of 4) and the patient presented with progressive disease (H) after 3 months of chemotherapy. London criteria have been proposed for interpretation of interim FDG PET/CT to achieve inter-center reproducibilities.<sup>[10]</sup> According to London criteria FDG uptake of tumor is scored according to relative uptake to surrounding background, mediastinum and liver with scores ranging from 1 to 5. Early studies indicate that scores of 4 and 5 in interim PET/CT studies are associated with progression and non-achievement of complete response in patients with high-grade non-Hodgkin's Lymphoma and Hodgkin's Lymphoma respectively.<sup>[11,12]</sup> This image illustrates various scores for interpretation of interim F-18 FDG PET/CT according to London criteria