title: Prognostic impact of clinician-based interpretation of 18F-fluorodeoxyglucose positron emission tomography/computed tomography reports obtained in patients with newly diagnosed diffuse large B-cell lymphoma.
abstract: The aim of this study was to evaluate the prognostic value of clinician interpretation of positron emission tomography/computed tomography (PET/CT) reports at mid-therapy, interim PET (I-PET) and after the end of first-line therapy (E-PET) in patients with diffuse large B-cell lymphoma (DLBCL). Four hundred and thirty patients were enrolled in this study comprising a total of 617 PET reports. Each report was evaluated by three expert hematologists randomly selected from a panel of nine. Reports were labeled positive or negative if all three interpreters agreed. All others were considered indeterminate. Indeterminate reports accounted for 59% of I-PET and 49% of E-PET reports. Two-year overall survival (OS) for patients with a positive, indeterminate and negative I-PET was 58%, 87% and 89% (p < 0.001), respectively. Two-year OS for patients with E-PET was 41%, 89% and 97% (p < 0.001) for positive, indeterminate and negative interpretation of PET/CT reports. Progression-free survival and OS did not differ significantly in patients with a negative and an indeterminate I-PET report. The use of well-defined reporting criteria, e.g. the Deauville five-point scale, is likely to reduce the number of scans perceived as indeterminate.
authors.affiliation: Department of Hematology, Odense University Hospital , Odense , Denmark.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Mylam
authors.forename: Tarec C
authors.initials: TC
authors.lastname: El-Galaly
authors.forename: Martin
authors.initials: M
authors.lastname: Hutchings
authors.forename: Peter
authors.initials: P
authors.lastname: Brown
authors.forename: Bodil
authors.initials: B
authors.lastname: Himmelstrup
authors.forename: Oke
authors.initials: O
authors.lastname: Gerke
authors.forename: Dorte
authors.initials: D
authors.lastname: Gillstrøm
authors.forename: Ida B
authors.initials: IB
authors.lastname: Sillesen
authors.forename: Lars
authors.initials: L
authors.lastname: Munksgaard
authors.forename: Bjarne B
authors.initials: BB
authors.lastname: Pedersen
authors.forename: Ilse
authors.initials: I
authors.lastname: Christiansen
authors.forename: Paw
authors.initials: P
authors.lastname: Jensen
authors.forename: Anne L
authors.initials: AL
authors.lastname: Nielsen
authors.forename: Lars M
authors.initials: LM
authors.lastname: Pedersen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Diffuse large B-cell lymphoma; PET/CT; prognostication