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Interim FDG-PET/CT in Hodgkin lymphoma: the prognostic role of the ratio between target lesion and liver SUVmax (rPET)

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Abstract

Objective

To evaluate the prognostic role of the ratio between target lesion and liver SUVmax (rPET) in patients with Hodgkin lymphoma (HL) undergoing interim FDG-PET/CT and to compare rPET with the 5-point Deauville Score (5p-DS).

Methods

Sixty-eight patients with HL undergoing interim FDG-PET/CT after first courses of chemotherapy were evaluated. The receiver operating characteristic (ROC) approach was applied to identify the optimal cutpoint of rPET with respect to progression free survival (PFS). The prognostic significance of rPET was compared with 5p-DS (scores 4 and 5 considered as positive). Positive predictive value (PPV) and negative predictive value (NPV) were calculated using the presence of an adverse event as the gold standard.

Results

The ROC analysis for rPET as a predictor of progression showed an optimal rPET cutpoint of 1.14. Both 5p-DS and rPET were strong outcome predictors (p < 0.001). Patients with negative 5p-DS and patients with rPET <1.14 had a similar two-year PFS (86 and 87 %, respectively). Patients with a positive 5p-DS had a 2-year PFS of 27 %, while patients with rPET >1.14 had a 2-year PFS of 15 %. 5p-DS and rPET cutoff of 1.14 showed a PPV of 58 versus 70 %, and a NPV of 85 versus 86 %, respectively.

Conclusions

rPET could be considered an accurate prognostic factor in patients with HL undergoing interim FDG-PET/CT. Larger prospective studies are needed to confirm these data.

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Authors and Affiliations

  1. Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy

    Salvatore Annunziata, Maria Lucia Calcagni, Alessandro Giordano & Vittoria Rufini

  2. Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy

    Annarosa Cuccaro & Stefan Hohaus

Authors
  1. Salvatore Annunziata
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  2. Annarosa Cuccaro
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  3. Maria Lucia Calcagni
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  4. Stefan Hohaus
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  5. Alessandro Giordano
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  6. Vittoria Rufini
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Corresponding author

Correspondence to Salvatore Annunziata.

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The authors declare that they have no conflict of interest.

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Annunziata, S., Cuccaro, A., Calcagni, M.L. et al. Interim FDG-PET/CT in Hodgkin lymphoma: the prognostic role of the ratio between target lesion and liver SUVmax (rPET). Ann Nucl Med 30, 588–592 (2016). https://doi.org/10.1007/s12149-016-1092-9

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  • DOI: https://doi.org/10.1007/s12149-016-1092-9

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