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Diagnostic accuracy of FDG PET/CT for clinical evaluation at the end of treatment of HL and NHL: a comparison of the Deauville Criteria (DC) and the International Harmonization Project Criteria (IHPC)

  • Federico Fallanca
  • Pierpaolo Alongi
  • Elena Incerti
  • Luigi Gianolli
  • Maria Picchio
  • Irfan Kayani
  • Jamshed BomanjiEmail author
Original Article

Abstract

Purpose

To evaluate the accuracy and prognostic value of FDG PET/CT for response assessment after treatment in patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) when using the Deauville Criteria (DC) and the International Harmonization Project Criteria (IHPC).

Methods

This retrospective study included 101 patients (35 HL, 66 NHL) who underwent early restaging FDG PET/CT after treatment. Scans were evaluated using the IHPC and DC. Two thresholds of positivity for the DC were used: a score of at least 3 (DC3, i.e. scores 3 – 5) and a score of at least 4 (DC4, i.e. a score of 4 or 5). Accuracy was assessed using conventional diagnostic procedures, multidisciplinary team case notes, further PET/CT scans and/or follow-up. Progression-free survival and overall survival were computed using the Kaplan-Meier method. The Cox proportional hazards model was used to identify predictors of outcome.

Results

Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FDG PET/CT for early restaging were, respectively, 92 %, 87 %, 74 %, 92 % and 86 % using DC4, 97 %, 76 %, 64 %, 98 % and 84 % using DC3, and 97 %, 67 %, 57 %, 98 % and 76 % using the IHPC. FDG PET/CT positivity was associated with a worse cumulative survival rate over a 2-year period when using DC4 in comparison with the IHPC (20 % vs. 49 %; p < 0.05) and DC3 (47 %; p < 0.05). Cox regression analysis showed different risks of progression in patients positive on FDG PET/CT using the IHPC, DC3 and DC4 (hazard ratios 1.57, 0.7 and 3.2, respectively).

Conclusion

FDG PET/CT using DC4 showed higher diagnostic accuracy for HL and NHL than FDG PET/CT using either the IHPC or DC3, indicating its value in predicting clinical outcome after treatment.

Keywords

Deauville Criteria International Harmonization Project Criteria Hodgkin lymphoma Non-Hodgkin lymphoma 18F-FDG PET/CT End of therapy Restaging 

Notes

Compliance with ethical standards

Funding

None.

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the principles of the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Federico Fallanca
    • 1
  • Pierpaolo Alongi
    • 1
    • 2
  • Elena Incerti
    • 1
  • Luigi Gianolli
    • 1
  • Maria Picchio
    • 1
  • Irfan Kayani
    • 3
  • Jamshed Bomanji
    • 3
    • 4
    Email author
  1. 1.Unit of Nuclear MedicineIRCCS San Raffaele Scientific InstituteMilanItaly
  2. 2.Nuclear Medicine Unit, Department of Radiological SciencesSan Raffaele G. Giglio InstituteCefalùItaly
  3. 3.University College London HospitalLondonUK
  4. 4.Department of Nuclear MedicineUniversity College Hospitals NHS Foundation TrustLondonUK

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