title: 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.
abstract: OBJECTIVE
  Interim 2-[(18)F]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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Nuclear Medicine, University Hospital of Brest, 5 avenue Foch, 29200 Brest, France.
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Le Roux
authors.forename: Thomas
authors.initials: T
authors.lastname: Gastinne
authors.forename: Steven
authors.initials: S
authors.lastname: Le Gouill
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Nowak
authors.forename: Caroline
authors.initials: C
authors.lastname: Bodet-Milin
authors.forename: Solène
authors.initials: S
authors.lastname: Querellou
authors.forename: Beatrice
authors.initials: B
authors.lastname: Mahe
authors.forename: Viviane
authors.initials: V
authors.lastname: Dubruille
authors.forename: Nicolas
authors.initials: N
authors.lastname: Blin
authors.forename: Pierre Yves
authors.initials: PY
authors.lastname: Salaun
authors.forename: Françoise
authors.initials: F
authors.lastname: Bodere-Kraeber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D038622:Internationality; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D019788:Fluorodeoxyglucose F18