title: The predictive role of interim positron emission tomography for Hodgkin lymphoma treatment outcome is confirmed using the interpretation criteria of the Deauville five-point scale.
abstract: A retrospective, international, multicenter study was undertaken to assess: (i) the prognostic role of 'interim' positron emission tomography performed during treatment with doxorubicin, bleomycin, vinblastine and dacarbazine in patients with Hodgkin lymphoma; and (ii) the reproducibility of the Deauville five-point scale for the interpretation of interim positron emission tomography scan. Two hundred and sixty patients with newly diagnosed Hodgkin lymphoma were enrolled. Fifty-three patients with early unfavorable and 207 with advanced-stage disease were treated with doxorubicin, bleomycin, vinblastine and dacarbazine ± involved-field or consolidation radiotherapy. Positron emission tomography scan was performed at baseline and after two cycles of chemotherapy. Treatment was not changed according to the results of the interim scan. An international panel of six expert reviewers independently reported the scans using the Deauville five-point scale, blinded to treatment outcome. Forty-five scans were scored as positive (17.3%) and 215 (82.7%) as negative. After a median follow up of 37.0 (2-110) months, 252 patients are alive and eight have died. The 3-year progression-free survival rate was 83% for the whole study population, 28% for patients with interim positive scans and 95% for patients with interim negative scans (P<0.0001). The sensitivity, specificity, and negative and positive predictive values of interim positron emission tomography scans for predicting treatment outcome were 0.73, 0.94, 0.94 and 0.73, respectively. Binary concordance amongst reviewers was good (Cohen's kappa 0.69-0.84). In conclusion, the prognostic role and validity of the Deauville five-point scale for interpretation of interim positron emission tomography scans have been confirmed by the present study.
authors.affiliation: Research and Medical Innovation Department, Centre Antoine Lacassagne, Nice, France gallamini.a@ospedale.cuneo.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Gallamini
authors.affiliation: Division of Imaging, King's College London, PET Centre, Guy's & St. Thomas' Hospital, London, UK.
authors.forename: Sally F
authors.initials: SF
authors.lastname: Barrington
authors.affiliation: Nuclear Medicine Department, PET Center, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Biggi
authors.affiliation: Medical Physics Unit, Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy.
authors.forename: Stephane
authors.initials: S
authors.lastname: Chauvie
authors.affiliation: Department of Radiology, Division of Nuclear Medicine, Mount Sinai Medical Center, New York, NY, USA.
authors.forename: Lale
authors.initials: L
authors.lastname: Kostakoglu
authors.affiliation: Radiotherapy and Nuclear Medicine Unit, Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Gregianin
authors.affiliation: Nuclear Medicine Department, Centre Universitaire Hospitalier Henri Mondor, Creteril, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Meignan
authors.affiliation: Clinical Oncology Department. Guy's & St. Thomas' Hospital, London, UK.
authors.forename: George N
authors.initials: GN
authors.lastname: Mikhaeel
authors.affiliation: PET & Cyclotron Unit, Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Annika
authors.initials: A
authors.lastname: Loft
authors.affiliation: Department of Oncology, Gdynia Oncology Centre & Department of Propedeutic Oncology, University of Gdansk, Poland.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Zaucha
authors.affiliation: Haematology Department, Peter MacCallum Cancer Centre, Melbourne, and University of Melbourne, Parkville Victoria, Australia.
authors.forename: John F
authors.initials: JF
authors.lastname: Seymour
authors.affiliation: Center for Cancer Imaging Peter Mac Callum Cancer Center, Melbourne, Australia.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hofman
authors.affiliation: Hematology Department, University of Florence, Careggi Hospital, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Rigacci
authors.affiliation: Cellular Biotechnology and Hematology Department, Sapienza University, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Pulsoni
authors.affiliation: Hematology-Oncology Division, Center for Lymphoma & Myeloma, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Morton
authors.initials: M
authors.lastname: Coleman
authors.affiliation: Department of Hematology & Bone Marrow Transplantation; Rambam Medical Center, Haifa, Israel.
authors.forename: Eldad J
authors.initials: EJ
authors.lastname: Dann
authors.affiliation: Hematology Department, University of Padua, Italy.
authors.forename: Livio
authors.initials: L
authors.lastname: Trentin
authors.affiliation: Hematology Department, Hopital Le Bocage, Dijon, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Casasnovas
authors.affiliation: Hematology Department - Niguarda Ca' Granda Hospital, Milan, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Rusconi
authors.affiliation: Hematology Department Centre Hospitalier Universitaire St. Louis, Paris, France.
authors.forename: Pauline
authors.initials: P
authors.lastname: Brice
authors.affiliation: Hematology Department, S. Gerardo University Hospital, Monza, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Bolis
authors.affiliation: Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Simonetta
authors.initials: S
authors.lastname: Viviani
authors.affiliation: Department of Hematology, SS Antonio e Biagio Hospital, Alessandria, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Salvi
authors.affiliation: Onco-Hematology Department, Modena University, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Luminari
authors.affiliation: Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Hutchings
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18