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Research ArticleOncology

Interim PET Evaluation in Diffuse Large B-Cell Lymphoma Using Published Recommendations: Comparison of the Deauville 5-Point Scale and the ΔSUVmax Method

Jan Rekowski, Andreas Hüttmann, Christine Schmitz, Stefan P. Müller, Lars Kurch, Jörg Kotzerke, Christiane Franzius, Matthias Weckesser, Frank M. Bengel, Martin Freesmeyer, Andreas Hertel, Thomas Krohn, Jens Holzinger, Ingo Brink, Uwe Haberkorn, Fonyuy Nyuyki, Daniëlle M.E. van Assema, Lilli Geworski, Dirk Hasenclever, Karl-Heinz Jöckel and Ulrich Dührsen
Journal of Nuclear Medicine January 2021, 62 (1) 37-42; DOI: https://doi.org/10.2967/jnumed.120.244145
Jan Rekowski
1Institut für Medizinische Informatik, Biometrie, und Epidemiologie, Universitätsklinikum, Essen, Germany
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Andreas Hüttmann
2Klinik für Hämatologie, Universitätsklinikum, Essen, Germany
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Christine Schmitz
2Klinik für Hämatologie, Universitätsklinikum, Essen, Germany
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Stefan P. Müller
3Klinik für Nuklearmedizin, Universitätsklinikum, Essen, Germany
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Lars Kurch
4Klinik und Poliklinik für Nuklearmedizin, Universitätsklinikum, Leipzig, Germany
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Jörg Kotzerke
5Klinik für Nuklearmedizin, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
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Christiane Franzius
6Zentrum für moderne Diagnostik (Zemodi), Zentrum für Nuklearmedizin und PET/CT, Bremen, Germany
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Matthias Weckesser
7Klinik für Nuklearmedizin, Universitätsklinikum, Münster, Germany
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Frank M. Bengel
8Klinik für Nuklearmedizin, Medizinische Hochschule, Hannover, Germany
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Martin Freesmeyer
9Klinik für Nuklearmedizin, Universitätsklinikum, Jena, Germany
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Andreas Hertel
10Klinik für Diagnostische und Therapeutische Nuklearmedizin, Klinikum, Fulda, Germany
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Thomas Krohn
11Klinik für Nuklearmedizin, Universitätsklinikum, Aachen, Germany
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Jens Holzinger
12Institut für Diagnostische Radiologie, Neuroradiologie, und Nuklearmedizin, Johannes Wesling Klinikum, Minden, Germany
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Ingo Brink
13Klinik für nuklearmedizinische Diagnostik und Therapie, Ernst von Bergmann Klinikum, Potsdam, Germany
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Uwe Haberkorn
14Radiologische Klinik und Poliklinik, Universitätsklinikum, Heidelberg, Germany
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Fonyuy Nyuyki
15Klinik für Nuklearmedizin, Brüderkrankenhaus St. Josef, Paderborn, Germany
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Daniëlle M.E. van Assema
16Department of Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Lilli Geworski
17Stabsstelle Strahlenschutz und Abteilung Medizinische Physik, Medizinische Hochschule, Hannover, Germany; and
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Dirk Hasenclever
18Institut für Medizinische Informatik, Statistik, und Epidemiologie, Universität Leipzig, Leipzig, Germany
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Karl-Heinz Jöckel
1Institut für Medizinische Informatik, Biometrie, und Epidemiologie, Universitätsklinikum, Essen, Germany
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Ulrich Dührsen
2Klinik für Hämatologie, Universitätsklinikum, Essen, Germany
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  • FIGURE 1.
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    FIGURE 1.

    Flow of patients in terms of iPET assessments and resulting subpopulations. DS = Deauville score.

  • FIGURE 2.
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    FIGURE 2.

    (A) Concordance between ΔSUVmax and Deauville score cutoff. (B) Kaplan–Meier event-free survival curves by concordance category. DS = Deauville score; EFS = event-free survival.

  • FIGURE 3.
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    FIGURE 3.

    AUC (A) and Cox regression hazard ratio (B; logarithmic scale) with 95% CI by method and time-to-event endpoint. DS = Deauville score; EFS = event-free survival; HR = hazard ratio; OS = overall survival; PFS = progression-free survival; TTP = time to progression.

  • FIGURE 4.
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    FIGURE 4.

    Kaplan–Meier event-free survival curves by iPET response according to ΔSUVmax (A) and Deauville score (B). DS = Deauville score; EFS = event-free survival.

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    TABLE 1

    Characteristics for All Evaluable Patients by Subpopulations Defined by Cutoffs for the 2 Methods

    CharacteristicsAll evaluableΔSUVmax > 66%ΔSUVmax ≤ 66%DS ≤ 3DS > 3
    No. of patients59653462326270
    Median age (y)62 (IQR, 51–70)62 (IQR, 51–70)62 (IQR, 50–69)62 (IQR, 52–70)61 (IQR, 50–70)
    Age > 60 y (n)308 (51.8%)274 (51.4%)34 (54.8%)174 (53.5%)134 (49.6%)
    Male sex (n)331 (55.5%)294 (55.1%)37 (59.7%)185 (56.7%)146 (54.1%)
    ECOG performance status ≥ 2 (n)59 (9.9%)47 (8.8%)12 (19.4%)23 (7.1%)36 (13.3%)
    Ann Arbor stage III or IV (n)349 (58.7%)304 (57.0%)45 (72.6%)173 (53.2%)176 (65.2%)
    Extranodal sites > 1 (n)192 (32.3%)166 (31.1%)26 (41.9%)94 (28.9%)98 (36.3%)
    Lactate dehydrogenase > ULN (n)329 (55.3%)289 (54.2%)40 (64.5%)151 (46.5%)178 (65.9%)
    International Prognostic Index (n)
     Low risk219 (36.8%)205 (38.5%)14 (22.6%)140 (43.1%)79 (29.3%)
     Low to intermediate risk155 (26.1%)137 (25.7%)18 (29.0%)83 (25.5%)72 (26.7%)
     High to intermediate risk124 (20.8%)110 (20.6%)14 (22.6%)61 (18.8%)63 (23.3%)
     High risk97 (16.3%)81 (15.2%)16 (25.8%)41 (12.6%)56 (20.7%)
    • DS = Deauville score; IQR = interquartile range; ECOG = Eastern Cooperative Oncology Group; ULN = upper limit of normal.

    • Data on International Prognostic Index was not available for 1 patient with ΔSUVmax > 66% and DS > 3.

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Journal of Nuclear Medicine: 62 (1)
Journal of Nuclear Medicine
Vol. 62, Issue 1
January 1, 2021
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Interim PET Evaluation in Diffuse Large B-Cell Lymphoma Using Published Recommendations: Comparison of the Deauville 5-Point Scale and the ΔSUVmax Method
Jan Rekowski, Andreas Hüttmann, Christine Schmitz, Stefan P. Müller, Lars Kurch, Jörg Kotzerke, Christiane Franzius, Matthias Weckesser, Frank M. Bengel, Martin Freesmeyer, Andreas Hertel, Thomas Krohn, Jens Holzinger, Ingo Brink, Uwe Haberkorn, Fonyuy Nyuyki, Daniëlle M.E. van Assema, Lilli Geworski, Dirk Hasenclever, Karl-Heinz Jöckel, Ulrich Dührsen
Journal of Nuclear Medicine Jan 2021, 62 (1) 37-42; DOI: 10.2967/jnumed.120.244145

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Interim PET Evaluation in Diffuse Large B-Cell Lymphoma Using Published Recommendations: Comparison of the Deauville 5-Point Scale and the ΔSUVmax Method
Jan Rekowski, Andreas Hüttmann, Christine Schmitz, Stefan P. Müller, Lars Kurch, Jörg Kotzerke, Christiane Franzius, Matthias Weckesser, Frank M. Bengel, Martin Freesmeyer, Andreas Hertel, Thomas Krohn, Jens Holzinger, Ingo Brink, Uwe Haberkorn, Fonyuy Nyuyki, Daniëlle M.E. van Assema, Lilli Geworski, Dirk Hasenclever, Karl-Heinz Jöckel, Ulrich Dührsen
Journal of Nuclear Medicine Jan 2021, 62 (1) 37-42; DOI: 10.2967/jnumed.120.244145
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Keywords

  • diffuse large B-cell lymphoma
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  • Deauville score
  • deltaSUVmax approach
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