title: The Deauville 5-Point Scale Improves the Prognostic Value of Interim FDG PET/CT in Extranodal Natural Killer/T-Cell Lymphoma.
abstract: OBJECTIVE
  The prognostic value of FDG PET/CT in extranodal natural killer/T-cell lymphoma (ENKTL) is still controversial. Furthermore, the utility of the Deauville 5-point scale (DS) in ENKTL is uncertain. Therefore, we designed a prospective study to examine the prognostic value of 3 methods of PET/CT analysis (International Harmonization Project [IHP] criteria, DS, and SUV-based assessment).
  
  
  METHODS
  Sixty patients with newly diagnosed untreated ENKTL were enrolled. PET/CT evaluation was performed before initial treatment (pretreatment) and midtreatment (interim). Interim PET/CT response was determined based on IHP criteria, DS, and change in FDG uptake (ΔSUVmax). International Harmonization Project criteria, DS, and ΔSUVmax were then examined for the ability to predict progression-free survival (PFS) and overall survival (OS).
  
  
  RESULTS
  Over a median follow-up of 23.5 months, interim PET/CT based on DS and ΔSUVmax were significant predictors of PFS and OS. After multivariate analysis, DS was an independent predictor of PFS (P < 0.001) and OS (P < 0.001). ΔSUVmax was an independent predictor of OS (P = 0.013) but not PFS (P = 0.054) and with a lower accuracy and positive predictive value than DS.
  
  
  CONCLUSIONS
  Interim PET/CT analysis with DS predicts unfavorable treatment outcomes of ENKTL patients, whereas interim PET/CT analysis based on IHP criteria and SUV-based assessment have limited prognostic value.
authors.affiliation: From the *Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China; †Stanford University, Santa Clara Valley Medical Center, San Jose, CA; and ‡Department of Oncology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Chong
authors.initials: C
authors.lastname: Jiang
authors.forename: Minggang
authors.initials: M
authors.lastname: Su
authors.forename: Russell Oliver
authors.initials: RO
authors.lastname: Kosik
authors.forename: Liqun
authors.initials: L
authors.lastname: Zou
authors.forename: Ming
authors.initials: M
authors.lastname: Jiang
authors.forename: Rong
authors.initials: R
authors.lastname: Tian
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016399:Lymphoma, T-Cell / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18