Prognostic value of interim FDG PET/CT in Hodgkin's lymphoma patients treated with interim response-adapted strategy: comparison of International Harmonization Project (IHP), Gallamini and London criteria.

Abstract : PURPOSE: Interim 2-[(18)F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) has shown to be an accurate predictor of prognosis in Hodgkin's lymphoma (HL). However, FDG PET response criteria are a matter of ongoing debate. The aim of this study was to confirm the prognostic value of interim PET/CT in HL patients treated with an interim response-adapted strategy and to compare the respective performances of different published criteria. METHODS: Newly diagnosed patients with HL underwent interim PET/CT after four courses of Adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). The treatment strategy was adapted according to prognostic factors at diagnosis and interim PET/CT and CT results. PET images were prospectively interpreted visually: a negative result was defined as no residual uptake above local background. All other findings were considered as positive. Retrospectively, interim PET/CT was analysed according to International Harmonization Project (IHP), Gallamini and London criteria RESULTS: The analysis included 90 patients; 6 of 31 patients with positive interim PET/CT and 7 of 59 patients with negative interim result presented treatment failure. The negative predictive value (NPV) and positive predictive value (PPV) for predicting 2-year progression-free survival (PFS) was 95 and 16%, respectively. With the other criteria, NPV remained very high (from 95 to 96%). The PPV increased from 19 to 45% according to the threshold used. Interim PET/CT was significantly correlated with PFS with Gallamini (p = 0.01) and London criteria (p < 0.0001). CONCLUSION: Our study confirms the high NPV of interim PET/CT for predicting treatment outcome in HL and a probably better prognostic value using a higher threshold for positivity even after four cycles of chemotherapy as used in Gallamini and London criteria.
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European Journal of Nuclear Medicine and Molecular Imaging, Springer Verlag (Germany), 2011, 38 (6), pp.1064-71. 〈10.1007/s00259-011-1741-0〉
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http://hal.univ-brest.fr/hal-00749883
Contributeur : Ghislaine Calvez <>
Soumis le : jeudi 8 novembre 2012 - 15:23:39
Dernière modification le : jeudi 15 mars 2018 - 14:10:54

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Pierre-Yves Le Roux, Thomas Gastinne, Steven Le Gouill, Emmanuel Nowak, Caroline Bodet-Milin, et al.. Prognostic value of interim FDG PET/CT in Hodgkin's lymphoma patients treated with interim response-adapted strategy: comparison of International Harmonization Project (IHP), Gallamini and London criteria.. European Journal of Nuclear Medicine and Molecular Imaging, Springer Verlag (Germany), 2011, 38 (6), pp.1064-71. 〈10.1007/s00259-011-1741-0〉. 〈hal-00749883〉

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