title: The HD12 panel of the German Hodgkin Lymphoma Study Group (GHSG): a quality assurance program based on a multidisciplinary panel reviewing all patients' imaging.
abstract: The purpose of this report is to determine the value of a central specialist radiologic review and to determine the image quality of computed tomography (CT) in Hodgkin disease. The HD12 protocol is a multicenter prospective randomized trial of the GHSG for advanced stages of Hodgkin disease. The indication and effectiveness of additional radiotherapy (30 Gy), in the area of initial bulky disease and of residual disease, following intensive chemotherapy using the BEACOPP schema (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone), is to be investigated. A multidisciplinary panel of radiation oncologists, radiologists, and medical oncologists reviews, blinded to treatment arms, the diagnostic imaging with comparison to the documentation forms. For patients with poor response to chemotherapy, the panel recommends radiotherapy independent of the randomization. This procedure guarantees that patients with a poor response to chemotherapy receive additional radiotherapy. Furthermore, the panel evaluates the quality of CT examinations in this multicenter study. Since July 1999, a total of 2607 CT of 371 patients have been evaluated. Helical CT showed significantly higher contrast enhancement and imaging quality than conventional CT (P < 0.001). CT from university hospitals was assessed as superior to that from other institutions (P < 0.001). Compared with the written disease documentation by the study centers, the panel assessed different extensions of disease in 814 of 2607 CT (31%), resulting in a change of stage in 17 of 371 patients (5%). After chemotherapy, 167 of 371 patients (45%) showed residual disease (>1.5 cm), and for 53 of 371 patients (14%) the panel recommended additional radiotherapy independent of the randomization arm. Patients with Hodgkin disease receive high-quality CT imaging. A central independent multidisciplinary panel markedly improves quality assurance for these study patients.
authors.affiliation: Department of Radiotherapy, University of Cologne, Germany. hans.eich@gmx.de
authors.forename: Hans Theodor
authors.initials: HT
authors.lastname: Eich
authors.forename: Susanne
authors.initials: S
authors.lastname: Staar
authors.forename: Axel
authors.initials: A
authors.lastname: Gossmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Engert
authors.forename: Jeremy
authors.initials: J
authors.lastname: Franklin
authors.forename: Markus
authors.initials: M
authors.lastname: Sieber
authors.forename: Barbara
authors.initials: B
authors.lastname: Krug
authors.forename: Volker
authors.initials: V
authors.lastname: Diehl
authors.forename: Klaus-Jürgen
authors.initials: KJ
authors.lastname: Lackner
authors.forename: Rolf-Peter
authors.initials: RP
authors.lastname: Müller
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D011786:Quality Control; D016032:Randomized Controlled Trials as Topic; D036542:Tomography, Spiral Computed; D014057:Tomography, X-Ray Computed / Q000592:standards