title: Utility of interim and end-of-treatment PET/CT in peripheral T-cell lymphomas: A review of 124 patients.
abstract: According to the updated guidelines for imaging in lymphoma, 18F-FDG positron emission tomography/computed tomography (PET/CT) is recommended for staging and evaluation of treatment response in FDG-avid lymphomas. The purpose of the study was to evaluate the utility of PET/CT in nodal peripheral T-cell lymphomas (PTCL). Patients with newly diagnosed nodal PTCL (peripheral T-cell lymphoma NOS, anaplastic large-cell lymphoma, or angioimmunoblastic T-cell lymphoma) seen at five Danish hematology centers during the period 2006 to 2012 were included, if they had been pretherapeutically staged with PET/CT. Medical records were reviewed for baseline clinical and follow-up information. Staging, interim (I-PET), and end-of-treatment PET/CT (E-PET) studies were centrally reviewed, and reported using the Deauville 5-point score (DS). A total of 124 patients fulfilled the inclusion criteria. The median age was 58 years, and 88% received CHOP/CHOP-like therapy. Five years PFS and OS of the study population was 36.8% (95% CI 27.3-46.4) and 49.7% (95% CI 38.9-59.6), respectively. The presence of PET/CT-ascertained lung and/or liver involvement was associated with a worse outcome. The sensitivity of PET/CT for detecting biopsy-defined bone marrow involvement was only 18% (95% CI 4-43). An interim DS >3 was not prognostic for worse OS and PFS among CHOP/CHOP-like treated patients in uni- or multivariate analyses. A DS >3 after treatment predicted a worse prognosis. In conclusion, I-PET was not predictive of outcome in CHOP/CHOP-like treated PTCL patients when using the DS. Prospective studies are needed to determine the optimal use of PET/CT in PTCL including the role of quantitative PET/CT analysis.
authors.affiliation: Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Tarec Christoffer
authors.initials: TC
authors.lastname: El-Galaly
authors.affiliation: Department of Hematology, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Martin Bjerregård
authors.initials: MB
authors.lastname: Pedersen
authors.affiliation: Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Hutchings
authors.affiliation: Department of Hematology, Odense University Hospital, Odense, Denmark.
authors.forename: Karen Juul
authors.initials: KJ
authors.lastname: Mylam
authors.affiliation: Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Jakob
authors.initials: J
authors.lastname: Madsen
authors.affiliation: Department of Hematology, Herlev Hospital, Copenhagen University Hospital, Denmark.
authors.forename: Anne Ortved
authors.initials: AO
authors.lastname: Gang
authors.affiliation: Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Martin
authors.initials: M
authors.lastname: Bøgsted
authors.affiliation: Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: de Nully Brown
authors.affiliation: Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Annika
authors.initials: A
authors.lastname: Loft
authors.affiliation: Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark.
authors.forename: Anne Lerberg
authors.initials: AL
authors.lastname: Nielsen
authors.affiliation: Department of Nuclear Medicine, Herlev Hospital, Copenhagen University Hospital, Denmark.
authors.forename: Helle Westergreen
authors.initials: HW
authors.lastname: Hendel
authors.affiliation: Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Victor
authors.initials: V
authors.lastname: Iyer
authors.affiliation: Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Lars Christian
authors.initials: LC
authors.lastname: Gormsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality; D017728:Lymphoma, Large-Cell, Anaplastic / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality; D016411:Lymphoma, T-Cell, Peripheral / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D019788:Fluorodeoxyglucose F18; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide