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. 2022 Sep 8;12:974029. doi: 10.3389/fonc.2022.974029

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Copyright © 2022 Winkelmann, Bücklein, Blumenberg, Rejeski, Ruzicka, Unterrainer, Schmidt, Dekorsy, Bartenstein, Ricke, von Bergwelt-Baildon, Subklewe and Kunz

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Examples of Over- and Underestimation with Metabolic Tumor Burden as Reference. PET/CT images of the patients color-coded in Figure 2 are shown. (A) shows a patient with disseminated hepatic lymphoma manifestation in whom the tumor burden is underestimated by RECIL and Lugano compared to MTV due to the limited number of target lesions. (B) shows a patient after 4 cycles of bridging therapy in whom only small portions of the retroperitoneal lymphoma manifestation are hypermetabolic. Therefore, compared to MTV, a relatively high tumor burden is detected according to the RECIL and Lugano criteria.