Importance of F18-Fluorodeoxy-D-2-Glucose Positron Emission Tomography (FDG-PET) for Staging and Therapy Control of Hodgkin’s Lymphoma in Childhood and Adolescence – Consequences for the GPOH-HD 2003 Protocol

Abstract

The prognosis for children and adolescents with Hodgkin’s lymphoma is excellent. However, many patients will show secondary malignancies 15–30 years after the initial diagnosis, which appears to be connected with the intensity of treatment during primary disease. In the GPOH-HD 95 trial, the indication for radiotherapy was limited to patients who did not show a complete remission after chemotherapy, as determined radiographically. In the future protocol, the indication for radiotherapy in patients with early-stage Hodgkin’s lymphoma should be further refined by using FDG-PET for evaluating the response to chemotherapy. Furthermore, in patients at an advanced stage of the disease, it should be determined if sequential FDG-PET research during chemotherapy can separate patients into subgroups with an excellent or a poor prognosis. This article gives a review of the current literature on FDG-PET in patients with Hodgkin’s lymphoma and outlines the consequences for future protocols.

Comparison of 18F Flurodeoxyglucose PET with Ga-67 scintigraphy and conventional imaging modalities in pediatric lymphoma

“…FDG PET is becoming increasingly incorporated into large, prospective, multi-institutional Children's Oncology Group and European trials of childhood lymphoma [29,30]. These trials should provide further information about the utility of FDG PET scanning in the detection of disease, in predicting response to therapy, and in monitoring patients who have completed therapy.…”

Role of FDG-PET in the Definition of Involved-Field Radiation Therapy and Management for Pediatric Hodgkin's Lymphoma

“…One study comparing the two modalities report the sensitivity, specificity, and positive and negative predictive values for PET-CT to be 78%, 98%, 94%, and 90% compared with 79%, 88%, 90%, and 46% for CT alone (26). Similarly, several reports have demonstrated the superiority of FDG-PET over that of CT in the initial evaluation of children with lymphoma, but initial evidence also suggests some unique challenges (10,(26)(27)(28)(29)(30)(31). Although the biologic properties of F-18 FDG in pediatric lymphomas should not differ substantially from that of adult lymphomas, an understanding of the specific physiologic patterns unique to children should be taken into account when assessing pediatric disorders with this modality (8,9,21,32).…”

Schlüssel-Technologie PET/CT - Nutzen, Kosten, Erwartungen

“…In der IOWA-Studie war eine komplette Tumorantwort (CR = complete remission) mit PET/CT am sichersten beurteilbar [13,15]. Aktuelle Überlegungen betreffen Vorschläge, das 11 C-Azetat bzw.…”