Medical scan transforming into a field of flowers, representing cancer remission.

Mantle Cell Lymphoma: Is Routine Imaging Worth It?

Elliot Brynn in Health & Wellness December 2025 • 4 min read.

"Rethinking surveillance strategies for patients in remission to reduce anxiety and improve outcomes."

Following lymphoma treatment, regular check-ups are crucial. However, there's debate on the best approach. These visits aim to spot any long-term side effects from treatment and check for recurrence through physical exams, lab tests, and often, imaging. For many, these checks offer reassurance.

The peace of mind after a check-up is valuable. However, using routine imaging to detect early relapse can raise anxiety levels around scan times. While doctors want to catch any recurrence early—some studies suggest early detection leads to better outcomes—routine follow-up strategies in lymphoma are being questioned.

New research is challenging the status quo of routine imaging for lymphoma, especially in specific subtypes like Mantle Cell Lymphoma (MCL). This article explores these findings, offering a fresh perspective on post-remission care.

The Dilemma of Routine Imaging in Lymphoma Follow-Up

Medical scan transforming into a field of flowers, representing cancer remission.

Studies on aggressive non-Hodgkin lymphoma and Hodgkin lymphoma (HL) show that surveillance efforts benefit a small fraction of patients since the goal is to cure for the majority. In diffuse large B-cell lymphoma (DLBCL) and HL, less than 5% of patients undergoing routine imaging find a relapse through this method. This exposes the remaining 95% to potential harm.

These harms include increased risk of secondary cancers from radiation and false positives, leading to unnecessary tests. Survival rates don't significantly differ between patients with imaging-detected relapse and those with clinically apparent relapse. Because of this, international guidelines are moving away from routine imaging in DLBCL and HL first remissions.

Increased anxiety related to scan anticipation.
Potential for secondary cancers due to radiation exposure.
Risk of false positives, leading to more testing.

Mantle cell lymphoma (MCL) presents a unique challenge. It is often considered an aggressive but incurable form of lymphoma. Unlike DLBCL and HL, relapse is common even after strong treatments like stem cell transplants. There's no global agreement on how to monitor MCL after remission. The latest ESMO guidelines suggest CT scans for up to five years post-treatment is optional. The concern is radiation exposure without clear proof that imaging-detected relapse improves survival.

Rethinking the Approach to MCL Surveillance

A recent study by Guidot et al. (2017) found routine imaging has limited value for MCL patients in remission. In 37% of patients in the study, relapse was found by routine imaging. There was no outcome differences between imaging detected relapse vs. clinical relapse. Only 4% of routine imaging led to relapse diagnosis, showing limited routine imaging for MCL.

More sensitive methods for detecting minimal residual disease, like multiparameter flow cytometry and PCR-based approaches, are emerging. These techniques can predict early relapse and drive preemptive therapy. However, they aren't widely available, and only some labs can perform them in a standard way.

For now, in the absence of clinical signs of disease progression, routine imaging in MCL offers little benefit, mirroring what's been found in other aggressive lymphomas. As methods evolve, the focus is shifting toward more tailored, less invasive surveillance strategies. New approaches like digital droplet PCR and next-generation sequencing are promising to refine post-remission surveillance.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1080/10428194.2017.1365863, Alternate LINK

Title: Questioning The Value Of Routine Imaging For Patients With Mantle Cell Lymphoma In First Remission

Subject: Cancer Research

Journal: Leukemia & Lymphoma

Publisher: Informa UK Limited

Authors: Tarec C. El-Galaly, Chan Yoon Cheah

Published: 2017-08-22

Everything You Need To Know

What is the role of regular check-ups after lymphoma treatment?

Following lymphoma treatment, regular check-ups are important to monitor long-term side effects and check for recurrence. These visits involve physical exams, lab tests, and imaging. While these checks offer reassurance, there's discussion about the best approach, balancing peace of mind with the potential for increased anxiety related to scan times and the potential harm of routine imaging.

What are the potential drawbacks of routine imaging in lymphoma surveillance, particularly in cases like Diffuse Large B-Cell Lymphoma (DLBCL) and Hodgkin Lymphoma (HL)?

Routine imaging in lymphoma follow-up, particularly in aggressive non-Hodgkin lymphoma and Hodgkin lymphoma (HL), benefits a small fraction of patients. In diffuse large B-cell lymphoma (DLBCL) and HL, less than 5% of patients undergoing routine imaging find a relapse through this method. The remaining 95% are exposed to potential harm, including increased risk of secondary cancers from radiation and false positives leading to unnecessary tests. International guidelines are moving away from routine imaging in DLBCL and HL first remissions because survival rates don't significantly differ between patients with imaging-detected relapse and those with clinically apparent relapse.

How does the approach to monitoring Mantle Cell Lymphoma (MCL) differ from other lymphomas like Diffuse Large B-Cell Lymphoma (DLBCL) and Hodgkin Lymphoma (HL) after remission?

Mantle cell lymphoma (MCL) presents a unique challenge because it's often considered an aggressive but incurable form of lymphoma, unlike DLBCL and HL. Relapse is common even after strong treatments like stem cell transplants. Global agreement on how to monitor MCL after remission is lacking. The latest ESMO guidelines suggest CT scans for up to five years post-treatment are optional. The concern is radiation exposure without clear proof that imaging-detected relapse improves survival.

What did the Guidot et al. (2017) study reveal about the value of routine imaging for Mantle Cell Lymphoma (MCL) patients in remission?

A study by Guidot et al. (2017) found routine imaging has limited value for Mantle Cell Lymphoma (MCL) patients in remission. In the study, 37% of patients had relapse found by routine imaging, but there were no outcome differences between imaging detected relapse vs. clinical relapse. Only 4% of routine imaging led to relapse diagnosis. This suggests that routine imaging may not significantly improve outcomes for MCL patients in remission, questioning its necessity.

What does 'rethinking' the approach to Mantle Cell Lymphoma (MCL) surveillance entail, and what factors should be considered?

Rethinking post-remission care involves a tailored approach to Mantle Cell Lymphoma (MCL) surveillance. Factors such as individual risk profiles, treatment history, and patient preferences should be considered. The goal is to balance the desire for early detection of relapse with the potential harms of routine imaging, including increased anxiety, radiation exposure, and unnecessary tests. Alternative strategies may include closer monitoring of clinical symptoms and biomarkers, reserving imaging for cases with specific indications. The focus shifts towards improving overall quality of life and reducing unnecessary interventions without compromising survival outcomes.