Original Article

Pediatric Radiology

, Volume 43, Issue 1, pp 86-92

Early interim FDG PET/CT prediction of treatment response and prognosis in pediatric Hodgkin disease—added value of low-dose CT

  • Anat IlivitzkiAffiliated withDepartment of Diagnostic Imaging, Rambam Health Care CampusDepartment of Pediatric Radiology, Rambam Health Care Campus Email author 
  • , Lea RadanAffiliated withDepartment of Nuclear Medicine, Rambam Health Care Campus
  • , Miriam Ben-ArushAffiliated withDepartment of Pediatric Oncology, Rambam Health Care Campus
  • , Ora IsraelAffiliated withDepartment of Nuclear Medicine, Rambam Health Care Campus
  • , Ayelet Ben-BarakAffiliated withDepartment of Pediatric Oncology, Rambam Health Care Campus

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Abstract

Background

Interim 18F-FDG PET helps predict outcome and tailor treatment in adults with Hodgkin disease (HD).

Objective

The purpose of this study was to assess predictive values of interim 18F-FDG PET/CT in children with HD and to define the potential added value to interim PET of low-dose CT.

Materials and methods

Children were prospectively enrolled August 2002–April 2007. PET/low-dose CT was performed at staging, after 2 cycles, at the end of treatment and during follow-up (mean 45 months). Treatment was unchanged regardless of interim results. PET and low-dose CT were read independently.

Results

Of 34 enrolled children (ages 3–17 years), 27 achieved complete response, 4 had progressive disease and 3 had relapse. Interim PET alone had positive and negative predictive values of 67% and 89%, respectively. Interim low-dose CT alone had positive and negative predictive values of 35% and 100%, respectively. Interim PET/CT had positive and negative predictive values of 75% and 96%, respectively.

Conclusions

Early interim PET/CT was a good predictor of outcome. Integrated PET and low-dose CT improved the predictive value in children with HD.

Keywords

Hodgkin disease Interim PET/CT Pediatric malignancy ALARA