Prognostic value of interim FDG PET/CT in Hodgkin’s lymphoma patients treated with interim response-adapted strategy: comparison of International Harmonization Project (IHP), Gallamini and London criteria

  • Pierre-Yves Le Roux
  • Thomas Gastinne
  • Steven Le Gouill
  • Emmanuel Nowak
  • Caroline Bodet-Milin
  • Solène Querellou
  • Beatrice Mahe
  • Viviane Dubruille
  • Nicolas Blin
  • Pierre Yves Salaun
  • Françoise Bodere-Kraeber
Original Article

DOI: 10.1007/s00259-011-1741-0

Cite this article as:
Le Roux, PY., Gastinne, T., Le Gouill, S. et al. Eur J Nucl Med Mol Imaging (2011) 38: 1064. doi:10.1007/s00259-011-1741-0

Abstract

Purpose

Interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) has shown to be an accurate predictor of prognosis in Hodgkin’s lymphoma (HL). However, FDG PET response criteria are a matter of ongoing debate. The aim of this study was to confirm the prognostic value of interim PET/CT in HL patients treated with an interim response-adapted strategy and to compare the respective performances of different published criteria.

Methods

Newly diagnosed patients with HL underwent interim PET/CT after four courses of Adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). The treatment strategy was adapted according to prognostic factors at diagnosis and interim PET/CT and CT results. PET images were prospectively interpreted visually: a negative result was defined as no residual uptake above local background. All other findings were considered as positive. Retrospectively, interim PET/CT was analysed according to International Harmonization Project (IHP), Gallamini and London criteria

Results

The analysis included 90 patients; 6 of 31 patients with positive interim PET/CT and 7 of 59 patients with negative interim result presented treatment failure. The negative predictive value (NPV) and positive predictive value (PPV) for predicting 2-year progression-free survival (PFS) was 95 and 16%, respectively. With the other criteria, NPV remained very high (from 95 to 96%). The PPV increased from 19 to 45% according to the threshold used. Interim PET/CT was significantly correlated with PFS with Gallamini (p = 0.01) and London criteria (p < 0.0001).

Conclusion

Our study confirms the high NPV of interim PET/CT for predicting treatment outcome in HL and a probably better prognostic value using a higher threshold for positivity even after four cycles of chemotherapy as used in Gallamini and London criteria.

Keywords

Interim FDG PET/CTHodgkin’s lymphomaResponse-adapted strategyAssessment criteria

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Pierre-Yves Le Roux
    • 1
  • Thomas Gastinne
    • 2
  • Steven Le Gouill
    • 2
  • Emmanuel Nowak
    • 3
  • Caroline Bodet-Milin
    • 4
  • Solène Querellou
    • 1
  • Beatrice Mahe
    • 2
  • Viviane Dubruille
    • 2
  • Nicolas Blin
    • 2
  • Pierre Yves Salaun
    • 1
  • Françoise Bodere-Kraeber
    • 4
  1. 1.Department of Nuclear MedicineUniversity Hospital of BrestBrestFrance
  2. 2.Department of HematologyUniversity Hospital of NantesNantesFrance
  3. 3.INSERM CIC 05-02 IFR148BrestFrance
  4. 4.Department of Nuclear MedicineUniversity Hospital of NantesNantesFrance