Response Assessment Criteria and Their Applications in Lymphoma: Part 1

Moghbel, Mateen; Kostakoğlu, Lale; Zukotynski, Katherine; Chen, Delphine L.; Nadel, Helen; Niederkohr, Ryan D.; Mittra, Erik

doi:10.2967/jnumed.115.166280

Cited by 23 publications

(16 citation statements)

References 59 publications

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“…The initial 2007 International Harmonization Project tumor response classifications have been updated, first with the 2009 Deauville 5-point scale (D5PS) and more recently by the 2014 Lugano Criteria, which incorporates the D5PS [28]. This standardization has allowed for unified, comparable response assessment and lead to numerous studies, across various lymphoma subtypes (including Hodgkin lymphoma), firmly establishing the prognostic importance of post treatment 18 F-FDG-PET/CT response and allowing for response adaptive therapies [29].…”

Section: Discussionmentioning

confidence: 99%

Imaging of Early Response to Predict Prognosis in the First-Line Management of Follicular Non-Hodgkin Lymphoma with Iodine-131-Rituximab Radioimmunotherapy

et al. 2017

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The purpose of this study was to evaluate prediction of prognosis after first-line radioimmunotherapy (RIT) of advanced follicular non-Hodgkin lymphoma (FL), by imaging with fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG-PET/CT) three months after induction treatment by Iodine-131-rituximab (131I-rituximab). Objective response was determined using the Deauville 5-point scale in 68 prospective clinical trial patients. Baseline 18F-FDG-PET/CT studies were used to calculate total-metabolic-tumor-volume (TMTV). Non-imaging studies included the Follicular lymphoma international prognostic index (FLIPI) and absolute baseline monocyte and lymphocyte counts. Patients were monitored for over ten years (median follow-up 59 months), and no patient was lost to follow-up. Complete response (CR) of 88% predicted excellent prognosis with median time-to-next-treatment (TTNT) not yet reached. Those patients (12%) who failed to achieve CR (Deauville ≤ 3) on 18F-FDG-PET/CT at three months had significantly poorer outcomes (p < 0.0001) with a median TTNT of 41 months. Requirement for re-treatment was predicted by FLIPI and absolute baseline monocyte count but not lymphocyte count. The TTNT was accurately predicted by 18F-FDG-PET/CT Deauville response at three months following first-line therapy of FL with RIT. Early response demonstrated by imaging does, therefore, foretell prognosis in the individual FL patients.

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Section: Discussionmentioning

confidence: 99%

Imaging of Early Response to Predict Prognosis in the First-Line Management of Follicular Non-Hodgkin Lymphoma with Iodine-131-Rituximab Radioimmunotherapy

et al. 2017

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“…Cancer immunotherapies often induce massive immune cell infiltration and consequently cause pronounced inflammation in tumors, increasing local metabolism levels (49). This inflammatory phenomenon presents tremendous challenges for the traditional therapeutic response evaluation methods, which often use a high metabolic rate as an indicator for cancer progression (50,51). For DLBCL, immunotherapies such as checkpoint inhibitors (15) and CAR-T-cell therapy (16) are rapidly advancing in clinical development.…”

Section: Discussionmentioning

confidence: 99%

Targeted PET imaging strategy to differentiate malignant from inflamed lymph nodes in diffuse large B-cell lymphoma

Tang

Salloum

Carney

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

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Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma in adults. DLBCL exhibits highly aggressive and systemic progression into multiple tissues in patients, particularly in lymph nodes. Whole-body 18 F-fluodeoxyglucose positron emission tomography ([ 18 F]FDG-PET) imaging has an essential role in diagnosing DLBCL in the clinic; however, [ 18 F]FDG-PET often faces difficulty in differentiating malignant tissues from certain nonmalignant tissues with high glucose uptake. We have developed a PET imaging strategy for DLBCL that targets poly[ADP ribose] polymerase 1 (PARP1), the expression of which has been found to be much higher in DLBCL than in healthy tissues. In a syngeneic DLBCL mouse model, this PARP1-targeted PET imaging approach allowed us to discriminate between malignant and inflamed lymph nodes, whereas [ 18 F]FDG-PET failed to do so. Our PARP1-targeted PET imaging approach may be an attractive addition to the current PET imaging strategy to differentiate inflammation from malignancy in DLBCL.PET/CT | PARP1 | [ 18 F]PARPi | diffuse large B-cell lymphoma | inflammation

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“…The absence of uptake above background for a lesion that was clearly seen pre‐therapy is termed a “complete metabolic response.” Additionally, some schemes will use a qualitative visual FDG uptake scale. For example, in the popular Deauville scale devised for lymphoma response evaluation, FDG uptake is assessed relative to normal body structures as follows: Deauville 1: FDG uptake at or local below background level Deauville 2: FDG uptake at or below blood pool level Deauville 3: FDG uptake at or below normal liver level Deauville 4: FDG uptake greater than normal liver level Deauville 5: FDG uptake much greater than normal liver level …”

Section: Introductionmentioning

confidence: 99%

“…FDG PET/CT is widely used in the clinical management of lymphoma both to stage patients with aggressive and FDG‐avid intermediate‐grade lymphomas and to assess response to treatment . The application of FDG PET/CT for following treatment response in lymphoma was motivated by the high sensitivity of FDG PET for the aggressive histologies such as diffuse large B‐cell lymphoma (DLBCL) and Hodgkins lymphoma (HL) and specificity for active disease in the post‐treatment setting.…”

Section: Introductionmentioning

confidence: 99%

“…FDG PET/CT has been widely validated as an endpoint for lymphoma treatment, with over 10 000 patients studied in the clinical trial literature, and is also commonly used in routine clinical management . More recently, it was demonstrated that an early or “interim” FDG PET, completed at approximately 2‐3 cycles of systemic therapy, is nearly equally predictive of relapse as reimaging at conventional time points; the interim FDG PET scan is now commonly used in clinical practice to make early decisions to change or augment ineffective therapy, and it has been explored as an integral imaging biomarker in clinical trials seeking to de‐escalate therapy for good early responders …”

Section: Introductionmentioning

confidence: 99%

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PET imaging for assessing tumor response to therapy

Mankoff

Katz

2018

Journal of Surgical Oncology

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Positron emission tomography (PET) is a radioisotope imaging technique capable of quantifying the regional distribution of molecular imaging probes targeted to biochemical pathways and processes allowing direct measurement of biochemical changes induced by cancer therapy, including the activity of targeted growth pathways and cellular populations. In this manuscript, we review the underlying principles of PET imaging, choices for PET radiopharmaceuticals, methods for tumor analysis and PET applications for cancer therapy response assessment including potential future directions.

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Response Assessment Criteria and Their Applications in Lymphoma: Part 1

Cited by 23 publications

References 59 publications

Imaging of Early Response to Predict Prognosis in the First-Line Management of Follicular Non-Hodgkin Lymphoma with Iodine-131-Rituximab Radioimmunotherapy

Imaging of Early Response to Predict Prognosis in the First-Line Management of Follicular Non-Hodgkin Lymphoma with Iodine-131-Rituximab Radioimmunotherapy

Targeted PET imaging strategy to differentiate malignant from inflamed lymph nodes in diffuse large B-cell lymphoma

PET imaging for assessing tumor response to therapy

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