Interim-treatment quantitative PET parameters predict progression and death among patients with hodgkin's disease

Tseng, Diane; Rachakonda, Leelanand; Su, Zheng; Advani, Ranjana H.; Horning, Sandra J.; Hoppe, Richard T.; Quon, Andrew; Graves, Edward E.; Loo, Billy W.; Tran, Phuoc T.

doi:10.1186/1748-717x-7-5

Cited by 41 publications

(24 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For OS, only high MTV was a strong predictor of poor prognosis (P 5 0.000). When Ann Arbor staging did not predict survival, higher MTV was associated with a significantly inferior event-free survival or PFS compared with the lower-MTV group, independent of the IPI (4,5). Similar to HL data, the combination of baseline MTV and interim PET performed after 2 cycles of chemotherapy findings improved the predictive value (8).…”

supporting

confidence: 68%

Metabolic Tumor Volume: We Still Need a Platinum-Standard Metric

Gallamini

Kostakoglu

2016

J Nucl Med

View full text Add to dashboard Cite

In this issue of The Journal of Nuclear Medicine, Cottereau et al.(1) retrospectively evaluate data compiled from a cohort of 106 peripheral T cell lymphoma patients, 50% of whom were previously enrolled in Lymphoma Study Association (LYSA) studies coordinated by 5 French and Belgian centers between 2006 and 2014. The objective was to determine the prognostic value of baseline total metabolic tumor volume (TMTV) calculated with adaptive thresholding methods as compared with TMTV measured with a fixed threshold. The methods used to calculate TMTV included the Daisne method, based on the tumorto-background ratios to segment tumor volumes, and the Nestle method, which compares the intensity of the tumor to that of the background. Despite substantial differences in cutoff values across different TMTV computing methods (631%), the authors reported excellent intraclass correlation coefficients (from 0.97 to 0.98) for discriminating low versus high TMTV.Tumor burden has long been considered an important prognostic marker in several lymphoma subtypes, hence its surrogates See page 276 such as bulky lesions, stage III-IV, or extranodal disease have been incorporated in several prognostic models including the IPI (international prognostic index), IPS (international prognostic score for Hodgkin lymphoma [HL]), FLIPI 1 and 2 (prognostic score for follicular lymphoma), MIPI (prognostic score for mantle cell lymphoma), PIT (prognostic index for peripheral T cell lymphoma), and AIP (prognostic model for angioimmunoblastic lymphoma). These prognostic models, however, are not considered sufficient to accurately stratify disease risk categories across patient populations. With the advent of advanced imaging techniques such as 18 F-FDG PET/CT and the availability of software offering sophisticated computer algorithms necessary for accurate tumor segmentation to calculate the sum of voxels of the tumor bulk, it became possible to quantify the functional activity and the total tumor burden.Earlier 18 F-FDG PET/CT studies found that a high metabolic tumor volume (MTV) was independently associated with progressionfree survival (PFS) and overall survival (OS) in HL patients treated with standard ABVD (doxorubicine, bleomycine, vinblastine, and dacarbazine), with or without involved-field radiotherappy (2,3), suggesting that pretherapy MTV as a measure of metabolically active whole-body tumor bulk was a predictor of outcome when the conventionally described tumor burden did not reach a significance. However, there is also evidence for contrasting results, showing that baseline MTV could not predict survival when IPS did, whereas percentage change (D) in both MTVand SUV max at interim PET was associated with PFS and OS (4). It is difficult to generalize these divergent results on the basis of retrospective analyses associated with no statistical design to determine a sufficiently high number of patient cohorts, inherent risk of bias for population selection, treatment protocols, and segmentation methodologies resulting in various MTV cut...

show abstract

supporting

confidence: 68%

Metabolic Tumor Volume: We Still Need a Platinum-Standard Metric

Gallamini

Kostakoglu

2016

J Nucl Med

View full text Add to dashboard Cite

show abstract

“…In this study, 5p-DS and rPET were obtained considering the same reference organ (liver parenchyma). Recent studies demonstrated that also semi-quantitative parameters (such as lesion SUVmax) have a prognostic significance in patients with HL [7,9,10]. In our population, rPET was documented to be a prognostic factor in patients with HL undergoing interim FDG-PET/CT.…”

Section: Discussionmentioning

confidence: 80%

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

et al. 2016

View full text Add to dashboard Cite

show abstract

“…In a recent study, pretreatment PET parameters MTV and maximum standardized uptake value did not correlate with outcome; however, change in MTV between interim and baseline studies was associated with median PFS (P 5 .01), as was maximum standardized uptake value (P 5 .02). 46 In addition, a recent analysis examined the prognostic importance of baseline (pretreatment) total MTV in untreated HL patients. 47 Baseline total MTV more accurately predicted outcome than tumor bulk and was prognostic in multivariate analysis for PFS.…”

Section: New Techniquesmentioning

confidence: 99%

The role of FDG-PET in defining prognosis of Hodgkin lymphoma for early-stage disease

Evens

Kostakoğlu

2014

Blood

View full text Add to dashboard Cite

Given the excellent survival rates for early-stage Hodgkin lymphoma (HL), the young age of many patients, and concerns regarding acute and late treatment-related toxicities, there is a desire to have a predictive tool that enables therapy to be tailored toward the individual patient. Early (or interim) 18F-fluorodeoxyglucose positron emission tomography with computerized tomography (FDG-PET/CT), as a test of tumor sensitivity to ongoing/planned therapy, has been shown to be prognostic for survival in HL. Based on results of interim FDG-PET/CT, therapy may be subsequently modified through minimization or via intensification for low- and high-risk patient populations, respectively (ie, response-adapted therapy). Important data have been generated to standardize the interpretability and reproducibility of interim FDG-PET/CT (eg, the Deauville 5-point system), and observational and noncontrolled prospective studies have produced evidence supporting the hypothesis that response-adapted therapy may potentially serve as a predictive tool. Furthermore, results from noninferiority phase 3 clinical trials randomizing early-stage HL patients with negative interim FDG-PET/CT to combined modality therapy versus chemotherapy alone have been reported. The current collective findings from these randomized early-stage HL studies have shown that acute relapse rates are lower with combined modality therapy, even in patients with negative interim FDG-PET/CT. Additional randomized response-adapted studies are ongoing and novel FDG-PET/CT applications involving quantitative techniques and innovative imaging modalities are being investigated to identify more robust imaging biomarkers. Treatment of early-stage HL remains a clinical management choice for physicians and patients to make with consideration of acute and long-term outcomes.

show abstract

Interim-treatment quantitative PET parameters predict progression and death among patients with hodgkin's disease

Cited by 41 publications

References 21 publications

Metabolic Tumor Volume: We Still Need a Platinum-Standard Metric

Metabolic Tumor Volume: We Still Need a Platinum-Standard Metric

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

The role of FDG-PET in defining prognosis of Hodgkin lymphoma for early-stage disease

Contact Info

Product

Resources

About