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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

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Abstract

Purpose

Interim 2-[18F]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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Authors and Affiliations

  1. Department of Nuclear Medicine, University Hospital of Brest, 5 avenue Foch, 29200, Brest, France

    Pierre-Yves Le Roux, Solène Querellou & Pierre Yves Salaun

  2. Department of Hematology, University Hospital of Nantes, Nantes, France

    Thomas Gastinne, Steven Le Gouill, Beatrice Mahe, Viviane Dubruille & Nicolas Blin

  3. INSERM CIC 05-02 IFR148, Brest, France

    Emmanuel Nowak

  4. Department of Nuclear Medicine, University Hospital of Nantes, Nantes, France

    Caroline Bodet-Milin & Françoise Bodere-Kraeber

Authors
  1. Pierre-Yves Le Roux
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  2. Thomas Gastinne
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  3. Steven Le Gouill
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  4. Emmanuel Nowak
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  5. Caroline Bodet-Milin
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  6. Solène Querellou
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  7. Beatrice Mahe
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  8. Viviane Dubruille
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  9. Nicolas Blin
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  10. Pierre Yves Salaun
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  11. Françoise Bodere-Kraeber
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Corresponding author

Correspondence to Pierre Yves Salaun.

Additional information

PYL and TG contributed equally to this manuscript.

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Le Roux, PY., Gastinne, T., Le Gouill, S. 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. Eur J Nucl Med Mol Imaging 38, 1064–1071 (2011). https://doi.org/10.1007/s00259-011-1741-0

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  • DOI: https://doi.org/10.1007/s00259-011-1741-0

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