RT Journal Article
SR Electronic
T1 Metabolic Tumor Volume for Response Prediction in Advanced-Stage Hodgkin Lymphoma
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 207
OP 211
DO 10.2967/jnumed.118.210047
VO 60
IS 2
A1 Jasmin Mettler
A1 Horst Müller
A1 Conrad-Amadeus Voltin
A1 Christian Baues
A1 Bernd Klaeser
A1 Alden Moccia
A1 Peter Borchmann
A1 Andreas Engert
A1 Georg Kuhnert
A1 Alexander Drzezga
A1 Markus Dietlein
A1 Carsten Kobe
YR 2019
UL http://jnm.snmjournals.org/content/60/2/207.abstract
AB 18F-FDG PET/CT for staging Hodgkin lymphoma may allow for accurate and reliable assessment of the metabolic tumor volume (MTV) as a baseline risk factor. Our aim was to analyze the prognostic impact of MTV measurements obtained by different means in advanced-stage Hodgkin lymphoma patients treated within the German Hodgkin Study Group HD18 trial. Methods: Within HD18, 310 patients underwent 18F-FDG PET/CT scanning for staging, which was available to the central review panel for quantitative analysis. We calculated the MTV by 4 different thresholding methods and performed receiver-operating-characteristic analysis to evaluate the potential for prediction of early response determined by PET after 2 cycles (PET-2) of dose-escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP). Logistic regression was used to evaluate its prognostic value concerning progression-free survival and overall survival. Results: All of the different MTV calculations predicted PET-2 response to a moderate and comparable degree (area under the curve, 0.62–0.63; P = 0.01–0.06). With none of the measuring methods did the receiver-operating-characteristic curves point to any unique cutoffs; rather, a wide range of possible cutoffs was indicated. None of the MTV measurements was prognostic for progression-free survival (hazard ratio, 1.2–1.5; P = 0.15–0.52) or overall survival (hazard ratio, 1.0–1.5; P = 0.95–0.27). Conclusion: Baseline MTV as determined by different means is a predictive factor for early response to eBEACOPP after 2 cycles. However, value as a prognostic factor after a highly effective PET-2–adapted treatment strategy could not be observed.