Nucl Med Mol Imaging.
2016 Mar;50(1):46-53. 10.1007/s13139-015-0368-7.
FDG PET/CT Response Assessment Criteria for Patients with Hodgkin's and Non-Hodgkin's Lymphoma at End of Therapy: A Multiparametric Approach
- Affiliations
-
- 1Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, ON, Canada. ur.metser@uhn.ca
- 2Office of Research and Development, Joint Department of Medical Imaging, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, Toronto, ON, Canada.
- 3Department of Radiation Oncology, Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
- KMID: 2313274
- DOI: http://doi.org/10.1007/s13139-015-0368-7
Abstract
- PURPOSE
Based on the International Harmonization Project (IHP) criteria, positron emission tomography (PET) response assessment of residual nodal masses in patients with lymphoma after completion of therapy is performed visually using mediastinal blood pool as the reference. The primary objective of this study was to define the optimal reference for PET response assessment. Secondary aim was to assess if morphological criteria on computed tomography (CT) may improve performance of PET.
METHODS
This institutional review board approved retrospective study included 137 patients, with Hodgkin's (n=43) or non-Hodgkin's lymphoma (n=94) assessed for residual masses (n=180) after completion of therapy with pathology and clinical and imaging surveillance data (mean, 19 months) as the standard of reference. Two readers independently assessed response by IHP and Deauville criteria. The addition of morphological parameters on CTwas assessed in relation to therapy response.
RESULTS
Based on the standard of reference, 36 patients (26.3 %) had residual lymphoma. For IHP and Deauville criteria, sensitivity, specificity and accuracy were 97.2 %, 97.2 % (p=1); 79.2 %, 92.1 % (p<0.001); and 83.9 %, 93.4 % (p=0.001), respectively. Of the morphological parameters assessed, only change in size over course of therapy was significant (p<0.003) and improved specificity for IHP-based interpretation to 90.4 % (p=0.008).
CONCLUSION
Using liver as the visual reference to determine PET positivity for lymphoma patients being assessed for residual masses at the end of therapy improves specificity, yet maintains the high sensitivity of PET in identifying residual disease. The addition of change in size after therapy improves specificity of PET when using IHP-based but not Deauville-based interpretation.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Staging and response assessment of lymphoma: a brief review of the Lugano classification and the role of FDG-PET/CT
- Predictive Efficacy of Interim Positron Emission Tomography/Computed Tomography (PET/CT) for the Treatment of Aggressive Lymphoma
- Extensive Extranodal Involvement of Rare Sites in Non Hodgkin's Lymphoma Detected on 18F- FDG PET-CT: A Case Report
- Versatile Role of 18 F-FDG PET/CT in a Patient with Pan-cerebellar Paraneoplastic Manifestation Due to Underlying Hodgkin’s Lymphoma
- Detection of Lymphomatous Marrow Infiltration using F-18 FDG PET at Initial Staging and after chemotherapy
