Prospective study of 18F-FDG PET in pediatric mediastinal lymphoma: A single center experience

Edeline, Véronique; Bonardel, G.; Brisse, H.; Fœhrenbach, H.; Pacquement, Hélène; Maszelin, P.; Gaillard, Jean-François; Michon, Jean; Neuenschwander, S.

doi:10.1080/10428190601162854

Cited by 16 publications

(5 citation statements)

References 10 publications

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“…Regarding the prediction of response to therapy, Edeline et al [23] reported that information gathered from end of treatment PET (visual assessment) in ten pediatric patients suffering from NHL did not provide further information to accurately predict outcome. In their series, only one out of five PET-positive pNHL patients showed a relapse, whereas four out of five PET-negative patients remained in remission.…”

Section: Resultsmentioning

confidence: 99%

Explorative analyses on the value of interim PET for prediction of response in pediatric and adolescent non-Hodgkin lymphoma patients

et al. 2013

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BackgroundThis study is to evaluate the predictive value of FDG-PET (PET) in pediatric and adolescent patients suffering from non-Hodgkin lymphoma (pNHL) in comparison to information provided by conventional imaging methods (CIM).MethodsImaging was performed at baseline and at interim (after 2 cycles of chemotherapy). The response assessment in PET was carried out visually and semi-quantitatively, the latter one by use of percentage decrease in SUVmax from baseline to interim (ΔSUVmax). The PET-based results were compared to the findings by CIM. Progression-free survival (PFS) was analyzed using Kaplan-Meier curves (KM) and log-rank test.ResultsThe final study included 16 patients (mean follow-up time, 60.2 months (range, 4.0 to 85.7 months)). Relapse occurred in four patients. Visual PET compared to CIM revealed higher sensitivity (3/4 vs 1/4) and NPV (6/7 vs 10/13), and equal PPV (3/9 vs 1/3), but lower specificity (6/12 vs 10/12) and accuracy (9/16 vs 11/16). False-positive findings in PET at interim were predominantly observed in patients presenting bulky disease (5/6), whereas CIM was true-negative in all of these cases. KM analyses revealed no significant differences in 5-year PFS neither for CIM (76.9% vs 66.7%; p = 0.67) nor for visual PET (85.7% vs 66.7%; p = 0.34) nor for ΔSUVmax (88.9% vs 57.1%; p = 0.12).ConclusionsThe predictive value of iPET in pediatric patients suffering from NHL was limited due to considerably high amount of false-positive findings, especially in patients suffering from bulky disease. However, due to our limited sample size, final conclusions cannot be drawn and, thus, call for further evaluation of PET in pNHL in larger and more homogenous patient series.

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Section: Resultsmentioning

confidence: 99%

Explorative analyses on the value of interim PET for prediction of response in pediatric and adolescent non-Hodgkin lymphoma patients

et al. 2013

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“…While anatomic and morphology-based imaging may show a residual mass, they are of limited accuracy in detecting HD manifestations in normally sized lymph nodes and extranodal sites (liver, spleen, bone marrow), in contrast with PET, which is more accurate in identifying active disease 15 . Study of 16 patients with mediastinal NHL and HD who underwent PET scanning showed that patients with negative scan had no relapse after up to 60 months of follow-up 16 . On the other hand, only 2 out of 5 patients with positive scan had histologically proven relapse, while in other 3 patients FDG uptake was of inflammatory/infectious nature.…”

Section: Discussionmentioning

confidence: 99%

Preliminary experience with 18f-fluoro-deoxy-glucose positron emission tomography/computed tomography in pediatric oncology patients

et al. 2011

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The aim of this study was to present preliminary experience with FDG PET/CT in pediatric oncology patients in National PET Center, Clinical Center of Serbia and to asses its impact on management of malignancies in children. 33 FDG PET/CT scans were performed on 30 pediatric patients. PET/CT imaging was performed for staging the disease, assessing therapy efficacy and diagnosing recurrent or metastatic disease. FDG PET/CT changed the stage of the disease in 60.6% (20/33) of the cases. 14 patients were down-staged after PET/CT, mostly patients with Hodgkin's disease, were in 7/10 cases PET/CT showed no activity in residual masses. Six scans led to upstage of the disease. In three cases PET/CT did not change the stage of disease, but has showed new distant metastases. In conclusion, FDG PET/CT showed important role in managing pediatric patients with different malignancies and was useful complementary diagnostic tool to conventional imaging methods.

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“…Studies in HL show a negative predictive value of PET scans of 97% and 96% for PET scans performed after two courses and at the end of chemotherapy, respectively 35, 36. This may prove to be true for PMBCL as well, as suggested by the good negative predictive value shown in a prospective evaluation of PET in a small series of 10 pediatric mediastinal NHLs 37. Similarly a comparison of PET and gallium scintigraphy in pediatric lymphoma patients showed a good negative predictive value for PET scans after two courses of chemotherapy (4 of 4 remained in remission) and at the end of chemotherapy (12 of 13 remained in remission) 38.…”

Section: Introductionmentioning

confidence: 87%

Primary mediastinal B‐cell lymphoma in the pediatric patient: Can a rational approach to therapy be based on adult studies?

Attias

Hodgson

Weitzman

2008

Pediatric Blood & Cancer

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The literature on adult and pediatric primary mediastinal B-cell lymphoma (PMBCL) was reviewed and compared. Biologically, adult PMBCL has more similarities to Hodgkin Lymphoma (HL) than diffuse large B-cell lymphoma (DLBCL). Pediatric studies suggest that the biology is similar to that in adults. Median age of children is 14.3 years and the overall survival (OS) is reported as 78.6% and event-free survival (EFS) as 67.4%. Adverse prognostic factors included LDH >500 and mass size over 10 cm, with a trend towards better survival in younger patients. Studies in adults show better survival with intensified chemotherapy and the addition of rituximab. Data on the use of radiation therapy show improved CR rates and survival with addition of involved field radiation therapy (IFRT). Positron emission tomography (PET) with computerized tomography (CT) imaging response-assessment after two courses and at therapy-end may allow for the rational use of IFRT in pediatric/adolescent patients who are more susceptible to development of adverse late effects.

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Prospective study of 18F-FDG PET in pediatric mediastinal lymphoma: A single center experience

Cited by 16 publications

References 10 publications

Explorative analyses on the value of interim PET for prediction of response in pediatric and adolescent non-Hodgkin lymphoma patients

Explorative analyses on the value of interim PET for prediction of response in pediatric and adolescent non-Hodgkin lymphoma patients

Preliminary experience with 18f-fluoro-deoxy-glucose positron emission tomography/computed tomography in pediatric oncology patients

Primary mediastinal B‐cell lymphoma in the pediatric patient: Can a rational approach to therapy be based on adult studies?

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