Substantial impact of FDG PET imaging on the therapy decision in patients with early-stage Hodgkin's lymphoma

Naumann, Ralph; Beuthien‐Baumann, Bettina; Reiss, Allan L.; Schulze, Jan; Hänel, Annette; Bredow, Jan; Kühnel, G; Kropp, J.; Hänel, Mathias; Laniado, Michael; Kotzerke, Jörg; Ehninger, Gerhard

doi:10.1038/sj.bjc.6601561

Cited by 153 publications

(66 citation statements)

References 23 publications

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“…In our cohort, only 1 (17%) out of 6 patients with unifocal FDG abnormality had positive BMB in contrast to 8/12 (67%) patients with multifocal FDG abnormalities. This observation highlights the significance of the ''pattern of FDG abnormality'' in the likelihood of bone/bone marrow disease involvement [27]. However, as no FDG-avid bone lesion was biopsied, the specificity of these findings cannot be calculated.…”

Section: Discussionmentioning

confidence: 73%

“…The meta-analysis by Pakos et al [1] summarising the results of 13 studies comprising a total of 587 patients showed that compared with BMB, the weighted sensitivity and specificity of FDG-PET were 51% and 91%, respectively. In the sub-group analysis, BMB showed better sensitivity in HL (76%) and in aggressive NHL, while FDG-PET gave false negative results in two-thirds of patients with bone marrow involvement in more indolent histological forms of NHL, leading to the conclusion that the role of PET/CT would be complementary [26][27][28][29][30][31][32][33]. Fuster et al [34] investigated the role of FDG-PET vs bone marrow disease in detecting bone marrow disease in patients with HL and NHL and found out that FDG-PET was more sensitive than BMB in HL and NHL with the exception of Grade 1 and 2 follicular lymphomas.…”

Section: Discussionmentioning

confidence: 99%

“…To establish this concept, FDG-avid sites, other than the conventional site of BMB (i.e. posterior iliac spine in the pelvis) should be biopsied and characterised histopathologically [27]. However, this was beyond the scope of our current study.…”

Section: Discussionmentioning

confidence: 99%

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Clinical utility of 18F FDG-PET/CT in the detection of bone marrow disease in Hodgkin's lymphoma

Muzahir¹,

Mian²,

Munir³

et al. 2012

The British Journal of Radiology

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Objective: The aim of the study was to evaluate the potential role of fludeoxyglucose (FDG)-positron emission tomography (PET)/CT in the detection of bone/bone marrow disease in patients with Hodgkin's lymphoma (HL). Methods: We retrospectively reviewed ( Results: There were 122 patients in total-81 (66.4%) were male and 41 (33.6%) were female. The age range was from 6 years to 78 years (mean 35.70 years). PET/CT was reported as negative for bone/bone marrow involvement in 85 (69.7%) patients, while the remaining 37 showed abnormal FDG uptake. The sensitivity of FDG-PET/CT was calculated to be 100%, the specificity was 76.57%, the negative predictive value was 76.57%, the positive predictive value was 29.72% and the diagnostic accuracy was 78.62%. Conclusion:18 F-FDG-PET/CT and BMB are complementary in the evaluation of bone marrow disease.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

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Clinical utility of 18F FDG-PET/CT in the detection of bone marrow disease in Hodgkin's lymphoma

Muzahir¹,

Mian²,

Munir³

et al. 2012

The British Journal of Radiology

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“…[11][12][13][14][15][16] Previous publications compared imaging techniques but do not report the impact of imaging on the more relevant final clinical stage, inclusive of bone marrow biopsy, and some publications included patients with HL and non-Hodgkin lymphoma (NHL). [17][18][19][20][21] Response assessment with the 5-PS has been reported by a number of investigators to have good interobserver agreement in a training set of 50 patients, 22 in a study of 260 advanced HL patients with international expert readers, 23 and in pediatric HL.…”

Section: Introductionmentioning

confidence: 99%

PET-CT for staging and early response: results from the Response-Adapted Therapy in Advanced Hodgkin Lymphoma study

Barrington

Kirkwood

Franceschetto

et al. 2016

Blood

157

101

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Key Points• PET-CT is the modern standard for staging Hodgkin lymphoma and can replace contrast enhanced CT in the vast majority of cases.• Agreement between expert and local readers is sufficient for the Deauville criteria to assess response in clinical trials and the community.International guidelines recommend that positron emission tomography-computed tomography (PET-CT) should replace CT in Hodgkin lymphoma (HL). The aims of this study were to compare PET-CT with CT for staging and measure agreement between expert and local readers, using a 5-point scale (Deauville criteria), to adapt treatment in a clinical trial: Response-Adapted Therapy in Advanced Hodgkin Lymphoma (RATHL). Patients were staged using clinical assessment, CT, and bone marrow biopsy (RATHL stage). PET-CT was performed at baseline (PET0) and after 2 chemotherapy cycles (PET2) in a response-adapted design. PET-CT was reported centrally by experts at 5 national core laboratories. Local readers optionally scored PET2 scans. The RATHL and PET-CT stages were compared. Agreement among experts and between expert and local readers was measured. RATHL and PET0 stage were concordant in 938 (80%) patients. PET-CT upstaged 159 (14%) and downstaged 74 (6%) patients. Upstaging by extranodal disease in bone marrow (92), lung (11), or multiple sites (12) on PET-CT accounted for most discrepancies. Follow-up of discrepant findings confirmed the PET characterization of lesions in the vast majority. Five patients were upstaged by marrow biopsy and 7 by contrast-enhanced CT in the bowel and/or liver or spleen. PET2 agreement among experts (140 scans) with a k (95% confidence interval) of 0.84 (0.76-0.91) was very good and between experts and local readers (300 scans) at 0.77 (0.68-0.86) was good. These results confirm PET-CT as the modern standard for staging HL and that response assessment using Deauville criteria is robust, enabling translation of RATHL results into clinical practice. (Blood. 2016;127(12):1531-1538

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“…Al tener similares resultados que la biopsia de médula ósea, la PET-FDG podría utilizarse en sustitución de esta técnica invasiva, que, por otro lado, presenta en algunos casos falsos negativos. En otros casos la PET-FDG serviría de guía para indicar el lugar más favorable a biopsiar y reducir el número de biopsias negativas [56][57][58][59][60][61][62][63][64][65][66][67][68] . Actualmente, los criterios de indicación de la PET en los linfomas son 1, 2 :…”

Section: Linfomasunclassified

La Tomografía por Emisión de Positrones (PET) en la práctica clínica oncológica

et al. 2004

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ResumenLa Tomografía por Emisión de Positrones con 18F-fluorodeoxiglucosa (PET-FDG) es una técnica de diagnóstico por imagen cuyo uso se ha generalizado en España durante la última década. Existen una serie de indicaciones concretas, en las cuales la PET-FDG ha demostrado sobradamente su superioridad con respecto a los métodos convencionales de diagnóstico. Es recomendable, por ello, realizar un estudio PET-FDG únicamente en las siguientes situaciones: la estadificación de tumores pulmonares y linfomas, la re-estadificación de tumores de tiroides, colorrectales, de cabeza-cuello, linfomas y melanomas; la localización de tumores de origen desconocido; la caracterización del nódulo pulmonar solitario; y, por último, el diagnóstico diferencial recidiva/radionecrosis en tumores cerebrales.

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Substantial impact of FDG PET imaging on the therapy decision in patients with early-stage Hodgkin's lymphoma

Cited by 153 publications

References 23 publications

Clinical utility of 18F FDG-PET/CT in the detection of bone marrow disease in Hodgkin's lymphoma

Clinical utility of 18F FDG-PET/CT in the detection of bone marrow disease in Hodgkin's lymphoma

PET-CT for staging and early response: results from the Response-Adapted Therapy in Advanced Hodgkin Lymphoma study

La Tomografía por Emisión de Positrones (PET) en la práctica clínica oncológica

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