Use of Positron Emission Tomography for Response Assessment of Lymphoma: Consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma

Juweid, Malik E.; Stroobants, Sigrid; Hoekstra, Otto S.; Mottaghy, Felix M.; Dietlein, Markus; Guermazi, Ali; Wiseman, Gregory A.; Kostakoğlu, Lale; Scheidhauer, Klemens; Buck, Andreas K.; Naumann, Ralph; Spaepen, Karoline; Hicks, Rodney J.; Weber, Wolfgang; Reske, Sven N.; Schwaiger, Markus; Schwartz, Lawrence H.; Zijlstra, Josée M.; Siegel, Barry A.; Cheson, Bruce D.

doi:10.1200/jco.2006.08.2305

Cited by 1,239 publications

(944 citation statements)

References 27 publications

Supporting

Mentioning

903

Contrasting

Unclassified

Order By: Relevance

“…Assessments during treatment or in clinical trials, however, may require quantification. [8][9][10] This is often challenging because cutoff levels of SUV to determine response to therapy are likely to depend on the tumor type and treatment administered and therefore need to be evaluated in prospective clinical trials. With the demonstration of the prognostic value of interim FDG-PET in classic Hodgkin lymphoma, different trials have now been initiated to use this information to direct individual treatment.…”

Section: Interpretation Of Pet Scansmentioning

confidence: 99%

“…12 In 2007, on the basis of the collective expertise of its members, the International Harmonization Project (IHP) subcommittee developed consensus recommendations for the use of FDG-PET in lymphoma. 8 Visual assessment alone was considered adequate for reading FDG-PET scans at the completion of therapy. The mediastinal blood pool uptake was recommended as the reference background activity to define FDG-PET positivity for a residual mass of 2 cm or greater, regardless of location.…”

Section: Interpretation Of Pet Scansmentioning

confidence: 99%

See 1 more Smart Citation

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Ansell

Armitage

2012

Mayo Clinic Proceedings

View full text Add to dashboard Cite

The use of sensitive and specific imaging techniques for accurate initial staging and evaluation of response to therapy in patients with lymphoma is essential for their optimal management. Fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) integrated with computed tomography (CT) has emerged as a powerful imaging tool and is being routinely used in staging, response evaluation, and posttreatment surveillance in patients with non-Hodgkin lymphoma and Hodgkin lymphoma. PET/CT is currently widely used in clinical practice, but the established clinical benefit is currently restricted to the posttreatment evaluation of Hodgkin lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma. Although used in other histologic subtypes and in other clinical situations including response assessment, its impact on patient outcome remains to be demonstrated. We performed a literature search of PubMed from 1999 to 2011 using the following keywords: PET scan, FDG-PET, PET/CT, lymphoma. This review addresses the challenges and controversies in the use of PET/CT scans in the management of patients with lymphoma. I n most patients with lymphoma, positron emission tomographic (PET) scans show abnormalities at diagnosis. Normal findings on the scan after therapy is highly predictive of a good prognosis, particularly in patients with diffuse large B-cell lymphoma (DLBCL), follicular lymphoma, and Hodgkin lymphoma. However, the optimal application of PET scans to the management of all patients with lymphoma remains problematic. The major controversies include the optimal timing of PET scans (for staging, during therapy, after completion of therapy, surveillance in remission), standardization of PET scan interpretation (visual interpretation compared with standard uptake value [SUV] calculation), what constitutes a positive PET scan result, and whether PET scans should be used to direct management (eg, does changing therapy in patients with positive findings on PET change outcome, should biopsies of sites with positive PET results be done routinely before a management change). Although a large body of literature addressing these topics exists, the studies are often difficult to compare, making definitive conclusions on all these issues difficult. The previously published studies often used different designs and variable reporting, making interpretation and comparison of the results difficult. In the early studies particularly, heterogeneous populations with different stages of disease and different histologic subtypes were included, making the clinical applicability of the studies' results difficult. More recent studies focusing on efforts to standardize the conduct and interpretation of PET scans and on riskadapted therapies based on interim PET scan results will, it is hoped, improve the management and outcome of patients with lymphoma. A literature search of PubMed from 1999 to 2011 was performed using the following keywords: PET scan, FDG-PET, PET/CT, lymphoma. We highlight the current standard use ...

show abstract

Section: Interpretation Of Pet Scansmentioning

confidence: 99%

Section: Interpretation Of Pet Scansmentioning

confidence: 99%

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Ansell

Armitage

2012

Mayo Clinic Proceedings

View full text Add to dashboard Cite

show abstract

“…The follow‐up PET/CT scan is acquired in the first half of therapy, typically after 1 to 2 weeks of chemotherapy. Treatment efficiency is then assessed by comparing changes between the two datasets 42 , 43 . As changes in SUV intensities are used to monitor treatment process, it is essential to discern changes induced by the treatment itself from any other nontreatment‐related factors.…”

Section: Resultsmentioning

confidence: 99%

A measure to evaluate deformable registration fields in clinical settings

Schreibmann

Pantalone

Waller

et al. 2012

J Applied Clin Med Phys

View full text Add to dashboard Cite

Deformable registration has migrated from a research topic to a widely used clinical tool that can improve radiotherapeutic treatment accuracy by tracking anatomical changes. Although various mathematical formulations have been reported in the literature and implemented in commercial software, we lack a straightforward method to verify a given solution in routine clinical use. We propose a metric using concepts derived from vector analysis that complements the standard evaluation tools to identify unrealistic wrappings in a displacement field. At the heart of the proposed procedure is identification of vortexes in the displacement field that do not correspond to underlying anatomical changes. Vortexes are detected and their intensity quantified using the CURL operator and presented as a vortex map overlaid on the original anatomy for rapid identification of problematic regions. We show application of the proposed metric on clinical scenarios of adaptive radiotherapy and treatment response assessment, where the CURL operator quantitatively detected errors in the displacement field and identified problematic regions that were invisible to classical voxel‐based evaluation methods. Unrealistic warping not visible to standard voxel‐based solution assessment can produce erroneous results when the deformable solution is applied on a secondary dataset, such as dose matrix in adaptive therapy or PET data for treatment response assessment. The proposed metric for evaluating deformable registration provides increased usability and accuracy of detecting unrealistic deformable registration solutions when compared to standard intensity‐based approaches. It is computationally efficient and provides a valuable platform for the clinical acceptance of image‐guided radiotherapy.PACS numbers: 87.57.nj; 87.55.Qr; 87.57.cp

show abstract

“…A consensus was reached recently by the Subcommittee of the International Harmonization Project regarding an optimal FDG-PET protocol for the assessment of treatment responses in lymphoma. 49 Importantly, for the first time, guidelines for the timing and interpretation of post-treatment PET studies of a specific disease entity were established.…”

Section: Assessment Of Tumor Response To Therapymentioning

confidence: 99%

Technology Insight: novel imaging of molecular targets is an emerging area crucial to the development of targeted drugs

et al. 2008

View full text Add to dashboard Cite

SUMMARYTargeted drugs hold great promise for the treatment of malignant tumors; however, there are several challenges for efficient evaluation of these drugs in preclinical and clinical studies. These challenges include identifying the 'correct', biologically active concentration and dose schedule, selecting the patients likely to benefit from treatment, monitoring inhibition of the target protein or pathway, and assessing the response of the tumor to therapy. Although anatomic imaging will remain important, molecular imaging provides several new opportunities to make the process of drug development more efficient. Various techniques for molecular imaging that enable noninvasive and quantitative imaging are now available in the preclinical and clinical settings, to aid development and evaluation of new drugs for the treatment of cancer. In this Review, we discuss the integration of molecular imaging into the process of drug development and how molecular imaging can address key questions in the preclinical and clinical evaluation of new targeted drugs. Examples include imaging of the expression and inhibition of drug targets, noninvasive tissue pharmacokinetics, and early assessment of the tumor response.

show abstract

Use of Positron Emission Tomography for Response Assessment of Lymphoma: Consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma

Cited by 1,239 publications

References 27 publications

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

Positron Emission Tomographic Scans in Lymphoma: Convention and Controversy

A measure to evaluate deformable registration fields in clinical settings

Technology Insight: novel imaging of molecular targets is an emerging area crucial to the development of targeted drugs

Contact Info

Product

Resources

About