The prognostic value of mid- and post-treatment [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in indolent follicular lymphoma

Zhou, Lu; Lin, Michael; Downe, Paul; Chong, Shanley; Ling, Silvia

doi:10.1007/s12149-014-0874-1

Cited by 22 publications

(17 citation statements)

References 24 publications

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“… FLIPI score d Treatment regimes (no.) Lu et al [ 6 ] (2014) Australia Retrospective 57 59 b (27–77) 26/31 I, 3 II, 7 III, 24 IV, 21 0, 2 1, 9 2, 19 3, 11 4, 8 5, 4 Unavailable, 4 6× R-CHOP, 57 Additional maintenance R, 45 Luminari et al [ 7 ] (2014) Italy Retrospective 202 56 b (33–75) 98/104 II, 16 III/IV, 186 0–2, 131 3–5, 71 R-CVP, 66 R-CHOP, 62 R-FM, 74 Zinzani et al [ 8 ] (2013) Italy Retrospective 142 63 a (25–83) 55/87 III, 65 IV, 77 NR R-FM Dupuis et al [ 9 ] (2012) Multinational Prospective 119 57 b (28–76) 63/56 I/II, 8 III/IV, 110 0–1, 17 2, 50 3–5, 49 6× R-CHOP, 113 2× additional R, 106 Trotman et al [ 10 ] (2011) Multinational Prospective 122 57 b (26–82) 67/55 I/II, 14 III/IV, 108 0–1, 28 2, 47 3–5, 47 6× R-CHOP + 2× R, 103 8× R-CVP, 19 Le Dortz et al [ 11 ] (2010) France Retrospective 45 60 a (47–78) 22/23 I/II, 5 III, 15 IV, 25 0–1, 9 2, 12 3–5, 24 6× R-CHOP Bishu et al [ 12 ] (2007) USA Retrospective …”

Section: Resultsmentioning

confidence: 99%

Prognostic value of interim and end-of-treatment FDG-PET in follicular lymphoma: a systematic review

2015

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This study aimed to systematically review the prognostic value of interim and end-of-treatment 18F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) in follicular lymphoma during and after first-line therapy. The PubMed/MEDLINE database was searched for relevant original studies. Included studies were methodologically assessed, and their results were extracted and descriptively analyzed. Three studies on the prognostic value of interim FDG-PET and eight studies on the prognostic value of end-of-treatment FDG-PET were included. Overall, studies were of poor methodological quality. In addition, there was incomplete reporting of progression-free survival (PFS) and overall survival (OS) data by several studies, and none of the studies incorporated the Follicular Lymphoma International Prognostic Index (FLIPI) in the OS analyses. Two studies reported no significant difference in PFS between interim FDG-PET positive and negative patients, whereas one study reported a significant difference in PFS between the two groups. Two studies reported no significant difference in OS between interim FDG-PET positive and negative patients. Five studies reported end-of-treatment FDG-PET positive patients to have a significantly worse PFS than end-of-treatment FDG-PET negative patients, and one study reported a non-significant trend towards a worse PFS for end-of-treatment FDG-PET positive patients. Three studies reported end-of-treatment FDG-PET positive patients to have a significantly worse OS than end-of-treatment FDG-PET negative patients. In conclusion, the available evidence does not support the use of interim FDG-PET in follicular lymphoma. Although published studies suggest end-of-treatment FDG-PET to be predictive of PFS and OS, they suffer from numerous biases and failure to correct OS prediction for the FLIPI.

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Section: Resultsmentioning

confidence: 99%

Prognostic value of interim and end-of-treatment FDG-PET in follicular lymphoma: a systematic review

2015

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“…At the heart of every comparison between the two methods is the trade-off between how early in the course of treatment a PET/CT scan is acquired and how accurate its predictions will be. This phenomenon is exemplified by studies in which end-of-treatment imaging was successful in significantly predicting outcomes but interim imaging was not (15,39,40). However, the difference in accuracy between interim and endof-therapy results has been marginal in many cases (38) and is often outweighed by the tremendous advantages of gleaning information as early as possible to determine whether to stay the course of treatment or change the management strategy.…”

Section: Resultsmentioning

confidence: 99%

“…These studies are highly varied in methodology, but they consistently corroborate the reliability of end-of-treatment imaging. Similar to HL, studies of NHL have shown that even when interim imaging fails to significantly distinguish between patients, posttreatment PET is reliably prognostic (39,40).…”

Section: End-of-treatment Response Asssessment In Nhlmentioning

confidence: 99%

Response Assessment Criteria and Their Applications in Lymphoma: Part 2

et al. 2016

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Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the diagnostic and predictive value of interim and end-of-treatment PET in HL and NHL; (2) the role of response-adapted therapy in the clinical management of lymphoma; and (3) the newly-emerging applications of interim and end-of-treatment PET in lymphoma.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNMMI is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNMMI designates each JNM continuing education article for a maximum of 2.0 AMA PRA Category 1 Credits. Physicians should claim only credit commensurate with the extent of their participation in the activity. For CE credit, SAM, and other credit types, participants can access this activity through the SNMMI website (http://www.snmmilearningcenter.org) through January 2020.Interim and end-of-treatment PET/CT have become central to the evaluation of Hodgkin and non-Hodgkin lymphoma. This review article seeks to aid clinical decision making by providing an overview of available data on the diagnostic and prognostic value of PET/CT imaging for response assessment and pretransplant evaluation in lymphoma. The relative strengths and limitations of these techniques in various disease subtypes and clinical scenarios are explored, along with their current standards for reporting and latest developments. Particular attention is given to response-adapted therapy, which is emerging as a cornerstone of clinical management. CTandPETwi th 18 F-FDG have come to play integral roles in evaluating Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). Soon after the incorporation of CT into staging and response assessment criteria, the advantages of using PET's metabolic data in conjunction with CT's structural information for these applications began to become apparent. This combination was especially helpful in the staging and restaging of lymphoma. It was shown to reliably identify the 80%-95% of posttreatment residual masses that are nonmalignant, thereby sparing patients unnecessary therapy and morbidity, and it was shown to alter staging in 20% of cases, most frequently upstaging patients by better detecting bone marrow involvement (1,2).After the integration of PET into the International Working Group criteria in 2007, PET/CT was widely adopted as a first-line imaging tool for evaluating end-of-treatment response in lymphoma (3). Subsequent studies laid the groundwork for the Deauville 5-point scale (D5PS) criteria, designed for the visual interpretation of PET scans (4). This was expanded by the Lugano guidelines, which established PET/CT as the modality of choice for staging and response assessment in 18 F-FDG-avid subtypes of lymphoma but maintained CT as the preferred tool for the small histologic subset with low or variable avidity (5). These guidelines are pa...

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“…Only three out four studies comparing OS and PET results showed a strict association, with a significantly lower survival in patients with a positive scan. Curiously in one single study38 only a trend toward significance was found between 3-Y PFS and scan results, with a PFS of 74.4% and 38.2% for PET-negative and positive patients, respectively (p=0.083). In the same study FDG-PET was predictive of OS, showing mean OS of 95.2 and 45 months in PET-negative and positive patients, respectively (p<0.001).…”

Section: Fdg-pet For Treatment Response Evaluation In Flmentioning

confidence: 95%

FDG-Pet Scan: A New Paradigm for Follicular Lymphoma Management.

Gallamini¹,

Borra²

2017

Mediterr J Hematol Infect Dis

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In the present review, the reader will be led to the most relevant observations that prompted oncologists and haematologist to consider FDG-PET/CT as a new paradigm for FL management in clinical practice. The role of functional imaging in lymphoma staging, restaging, prognostication, and metabolic tumour volume computing will be reviewed in detail. Moreover, a special focus will be addressed to technical and practical aspects of PET scan reporting, which have been set during the last decade to ensure the reproducibility of the therapeutic results. Finally, the predictive role of PET/CT on long-term treatment outcome will be compared with another well-known prognosticator as minimal residual disease (MRD) detection by Immunoglobulin gene rearrangement assessment.

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The prognostic value of mid- and post-treatment [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) in indolent follicular lymphoma

Abstract: Post-treatment PET is predictive of OS in indolent FL. It identifies patients who might benefit from more intensive follow-up, enrolment in clinical trials or second-line therapy. Mid-treatment PET scan results did not appear to predict long-term treatment outcomes.

Cited by 22 publications

References 24 publications

Prognostic value of interim and end-of-treatment FDG-PET in follicular lymphoma: a systematic review

Prognostic value of interim and end-of-treatment FDG-PET in follicular lymphoma: a systematic review

Response Assessment Criteria and Their Applications in Lymphoma: Part 2

FDG-Pet Scan: A New Paradigm for Follicular Lymphoma Management.

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