Generic placeholder image

Current Medical Imaging


ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Evaluation of the Reliability of Interim PET/CT in the Hodgkin Lymphoma

Author(s): Rafet Eren, Cihan Gündoğan, Ceyda Aslan, Alper Koç, Mehmet Hilmi Doğu, Şermin Altındal, Osman Yokuş, Elif Suyanı and Tevfik Fikret Çermik*

Volume 16, Issue 1, 2020

Page: [59 - 64] Pages: 6

DOI: 10.2174/1573405615666190206154847

Price: $65


Introduction: Positron-emission tomography (PET)/computerized tomography (CT) with 18F-fludeoxyglucose (FDG) has been come into use for risk assessment of Hodgkin lymphoma (HL) patients in recent years. The aim of our study is to evaluate the reliability of interim PET results according to Deauville score (DS), and also to compared PET findings with tumor reduction on CT.

Methods: Forty-two HL patients (median 39, range 19-75 y, 27 M, 15 F) were retrospectively evaluated with pre, interim and post-treatment PET/CT imaging. PET/CT imaging was obtained 60 min after the intravenous administration of 3.7-5.2 MBq/kg 18F-FDG.

Results: The negative predictive value of the interim PET was 89%. Four (10.5%) of the 38 interim PET-negative patients became post-treatment PET-positive. According to CT, 15 patients were in complete remission (CR), 27 (64.6%) patients were in partial remission (PR) or stable disease (SD).

Conclusion: The negative predictive value of interim PET was not satisfactory considering the treatment rate of over 80% of HL. Additionally, high rate of interim PET-negative patients’ conversion to PET-positive post-treatment state was considered as unexpected.

Keywords: Hodgkin lymphoma, interim PET, CT scan, 18F-fludeoxyglucose, deauville score, tumor.

Graphical Abstract
Diehl V, Stein H, Hummel M, Zollinger R, Connors JM. Hodgkin’s lymphoma: biology and treatment strategies for primary, refractory, and relapsed disease. Hematology (Am Soc Hematol Educ Program) 2003; 2003: 225-47.
[] [PMID: 14633784]
Gallamini A, Kostakoglu L. Interim FDG-PET in Hodgkin lymphoma: a compass for a safe navigation in clinical trials? Blood 2012; 120(25): 4913-20.
[] [PMID: 22932799]
Townsend W, Linch D. Hodgkin’s lymphoma in adults. Lancet 2012; 380(9844): 836-47.
[] [PMID: 22835602]
National Comprehensive Cancer Network. pdf2018.
Eichenauer DA, Engert A, André M, et al. ESMO guidelines working group. Hodgkin’s lymphoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2014; 25(3): 70-5.
Hasenclever D, Diehl V. A prognostic score for advanced Hodgkin’s disease. International prognostic factors project on advanced Hodgkin’s disease. N Engl J Med 1998; 339(21): 1506-14.
[] [PMID: 9819449]
Meignan M, Gallamini A, Itti E, Barrington S, Haioun C, Polliack A. Report on the third international workshop on interim positron emission tomography in lymphoma held in Menton, France, 26-27 September 2011 and Menton 2011 consensus. Leuk Lymphoma 2012; 53(10): 1876-81.
[] [PMID: 22432519]
Gallamini A, Hutchings M, Rigacci L, et al. Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin’s lymphoma: a report from a joint Italian-Danish study. J Clin Oncol 2007; 25(24): 3746-52.
[] [PMID: 17646666]
Rankin SC. Assessment of response to therapy using conventional imaging. Eur J Nucl Med Mol Imaging 2003; 30: S56-64.
[] [PMID: 12664137]
Gupta RK, Gospodarowicz MK, Lister TA. Clinical evaluation and staging. In: Mauch P, Armitage JO, Diehl V, Hoppe R, Weiss LM, Eds. Hodgkin’s Disease. Philadelphia, PA: Lippincott Williams & Wilkins 1999; pp. 223-40.
Canellos GP. Residual mass in lymphoma may not be residual disease. J Clin Oncol 1988; 6(6): 931-3.
[] [PMID: 3373263]
Lister TA, Crowther D, Sutcliffe SB, et al. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds meeting. J Clin Oncol 1989; 7(11): 1630-6.
[] [PMID: 2809679]
Barrington SF, Mikhaeel NG, Kostakoglu L, et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the international conference on malignant lymphomas imaging working group. J Clin Oncol 2014; 32(27): 3048-58.
[] [PMID: 25113771]
Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol 2014; 32: 3059-68.
[] [PMID: 25113753]
Gallamini A, Barrington SF, Biggi A, et al. The predictive role of interim positron emission tomography for Hodgkin lymphoma treatment outcome is confirmed using the interpretation criteria of the Deauville five-point scale. Haematologica 2014; 99(6): 1107-13.
[] [PMID: 24658820]
Juweid ME, Stroobants S, Hoekstra OS, et al. Imaging subcommittee of international harmonization project in lymphoma. use of positron emission tomography for response assessment of lymphoma: consensus of the imaging subcommittee of international harmonization project in lymphoma. J Clin Oncol 2007; 25(5): 571-8.
[] [PMID: 17242397]
Evens AM, Kostakoglu L. The role of FDG-PET in defining prognosis of Hodgkin lymphoma for early-stage disease. Hematology (Am Soc Hematol Educ Program) 2014; 2014(1): 135-43.
[] [PMID: 25696846]
Fallanca F, Alongi P, Incerti E, et al. Diagnostic accuracy of FDG PET/CT for clinical evaluation at the end of treatment of HL and NHL: a comparison of the Deauville Criteria (DC) and the International Harmonization Project Criteria (IHPC). Eur J Nucl Med Mol Imaging 2016; 43(10): 1837-48.
[] [PMID: 27154522]
Rigacci L, Puccini B, Zinzani PL, et al. The prognostic value of positron emission tomography performed after two courses (INTERIM-PET) of standard therapy on treatment outcome in early stage Hodgkin lymphoma: A multicentric study by the fondazione italiana linfomi (FIL). Am J Hematol 2015; 90(6): 499-503.
[] [PMID: 25720750]
Kostakoglu L, Gallamini A. Interim 18F-FDG PET in Hodgkin lymphoma: would PET-adapted clinical trials lead to a paradigm shift? J Nucl Med 2013; 54(7): 1082-93.
[] [PMID: 23818548]
Mesguich C, Cazeau AL, Bouabdallah K, et al. Hodgkin lymphoma: a negative interim-PET cannot circumvent the need for end-of-treatment-PET evaluation. Br J Haematol 2016; 175(4): 652-60.
[] [PMID: 27539369]
Rossi C, Kanoun S, Berriolo-Riedinger A, et al. Interim 18F-FDG PET SUVmax reduction is superior to visual analysis in predicting outcome early in Hodgkin lymphoma patients. J Nucl Med 2014; 55(4): 569-73.
[] [PMID: 24566003]
Milgrom SA, Pinnix CC, Chuang H, et al. Early-stage Hodgkin lymphoma outcomes after combined modality therapy according to the post-chemotherapy 5-point score: can residual pet-positive disease be cured with radiotherapy alone? Br J Haematol 2017; 179(3): 488-96.
[] [PMID: 28832956]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy