title: Interim [(18)F]fluorodeoxyglucose positron emission tomography imaging in stage I-II non-bulky Hodgkin lymphoma: would using combined positron emission tomography and computed tomography criteria better predict response than each test alone?
abstract: Our objective was to validate the International Harmonization Project (IHP) positron emission tomography (PET) response criteria and correlate with the Deauville criteria and diagnostic computed tomography-based (dCT) lesion size changes. All patients were recruited prospectively to the Cancer and Leukemia Group B (CALGB) 50203 trial for the treatment of stage I-II, non-bulky Hodgkin lymphoma (HL). [(18)F]Fluorodeoxyglucose (FDG) PET and dCT were performed at baseline and after two doxorubicin, vinblastine and gemcitabine (AVG) cycles (PET-2, dCT-2) in 88 patients. IHP and Deauville criteria and percent decrease in the sum of the products of the perpendicular diameters (%SPPD) after two cycles were correlated with progression-free survival (PFS). After a median follow-up of 3.3 years, 23.9% of patients relapsed/progressed (3-year PFS 77%). By IHP, the 2-year PFS was 88% and 54% for PET-2 negative and positive groups, respectively (p = 0.0009). Similar results were obtained for Deauville criteria. In a univariate analysis, PET-2 predicted PFS better than %SPPD, and in a combinatorial analysis, in the PET-2 positive group, a negative dCT-2 increased PFS by 27-35%. However, some confidence intervals were large due to small sample sizes. In conclusion, IHP and Deauville criteria-based interpretation of PET-2 was strongly associated with 2-year PFS. The combined analysis of PET-2 with dCT-2 suggested a better predictive value for PFS compared to either test alone. Further studies are under way to confirm these findings.
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA. lale.kostakoglu@mssm.edu
authors.forename: Lale
authors.initials: L
authors.lastname: Kostakoglu
authors.forename: Heiko
authors.initials: H
authors.lastname: Schöder
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Johnson
authors.forename: Nathan C
authors.initials: NC
authors.lastname: Hall
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Schwartz
authors.forename: David J
authors.initials: DJ
authors.lastname: Straus
authors.forename: Ann S
authors.initials: AS
authors.lastname: LaCasce
authors.forename: Sin-Ho
authors.initials: SH
authors.lastname: Jung
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Bartlett
authors.forename: George P
authors.initials: GP
authors.lastname: Canellos
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Cheson
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D019788:Fluorodeoxyglucose F18; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18