title: An evaluation of the predictive value of mid-treatment 18F-FDG-PET/CT scans in pediatric lymphomas and undefined criteria of abnormality in quantitative analysis.
abstract: Our purpose was to evaluate quantitative mid-treatment fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT scans in predicting the quantitative result of the end of treatment 18F-FDG PET/CT scan. With approval of Emory's Institutional Review Board, data were extracted from 273 existing 18F-FDG PET/CT scans of 143 pediatric patients performed for evaluation of lymphoma. The inclusion criteria were the availability of an initial staging scan (D0) and a mid-treatment scan after 1 to 3 cycles of chemotherapy (D1) and a post-treatment scan (D2). Absolute and relative changed of D1 compared to D0 were measured and their values in predicting D3 values were determined. Analysis was performed on a lesion basis (N=78) in 18 patients with an average of 4.3 lesions per patients. Results showed that the predictive value depended on the value selected as significant for the predictors (D1 SUV and D1 %SUV), and on the limit between negative and positive selected for the predicted value D2 SUV. If the maximum SUV<2.0 in D2 was the limit for negative, the negative predictive value if D1<4 was 0.84%. If positive was defined as D2>3.0, the positive predictive value of D1>4 was 100%. In that way outcome was predictable with absolute certainty in as many as 71% of the lesions with a single limit for D1 and D2. In conclusion, in this limited retrospective study the positive predictive value of the mid-treatment scan, was high for the post-treatment result for patient and lesion response seen on D2.
authors.affiliation: Department of Radiology, University of Arkansas for Medical Sciences (UAMS), Little Rock, USA. dr.junezhu@gmail.com.
authors.forename: Hongyun J
authors.initials: HJ
authors.lastname: Zhu
authors.forename: Raghuveer
authors.initials: R
authors.lastname: Halkar
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
authors.forename: Michael L
authors.initials: ML
authors.lastname: Goris
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008223:Lymphoma / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D064847:Multimodal Imaging / Q000706:statistics & numerical data*; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18