Validation of deauville score for response evaluation in hodgkin's lymphoma

Background Assessing treatment response in Hodgkin's lymphoma using 18FDG PET/CT can be challenging due to the nature of false positive of uptaking. This study aims to employ quantitative assessments and create a predictive model for treatment response using newly suggested Criteria in Hodgkin’s lymphoma patients. Methods 62 individuals diagnosed with Hodgkin's lymphoma and treated with chemotherapy were recruited for the research. Up to 6 lesions per patient were selected and delighted for evaluation, and the optimal cutoff was determined using Youden analysis. Predictive parameters for treatment response were identified using the LASSO model, and the new Criteria were evaluated by calibration plot and decision curve analysis (DCA). Results The analysis of 229 lesions led to the development of novel criteria based on the deltaSUVmax, resulting in a NPV of 0.81 and a PPV of 0.86. The LASSO model achieved an AUC of 0.76, with gender, stage, weight, TMV, SUVmaxM, and SUVmeanL identified as significant predictive parameters. Comparative assessment using calibration plots and DCA revealed that the new Criteria delivered more precise outcomes than the conventional visual Criteria. Conclusion Precise evaluation is essential in clinical trials, and continuous efforts are being made to improve the accuracy of response assessment Criteria. Our study found that PET parameters showed a superior specificity to the Deauville Criteria for predicting recurrence/relapse in Hodgkin's lymphoma.

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Using Deauville Scoring to Guide Consolidative Radiotherapy in Diffuse Large B-Cell Lymphoma

Yau,

Low,

Ong

et al. 2024

Cancers

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Background: The most common aggressive lymphoma in adults is diffuse large B-cell lymphoma (DLBCL). Consolidative radiotherapy (RT) is often administered to DLBCL patients but guidelines remain unclear, which could lead to unnecessary RT. We aimed to evaluate the value of end-of-treatment PET-CT scans, interpreted using the Deauville score (DV), to guide the utilization of consolidative RT, which may help spare low-risk DLBCL patients from unnecessary RT. Methods: We included all DLBCL patients diagnosed between 2010 and 2022 at the National Cancer Centre Singapore with DV measured at the end of the first-line chemoimmunotherapy. The outcome measure was time-to-progression (TTP). The predictive value of DV for RT was assessed based on the interaction effect between the receipt of RT and DV in Cox regression models. Results: The data of 349 patients were analyzed. The median follow-up time was 38.1 months (interquartile range 34.0–42.3 months). RT was associated with a significant improvement in TTP amongst the DV4-5 patients (HR 0.33; 95%CI 0.13–0.88; p = 0.027) but not the DV1-3 patients (HR 0.85; 95%CI 0.40–1.81; p = 0.671) (interaction’s p = 0.133). Multivariable analysis reported that RT was again significantly associated with improved TTP among the DV4-5 patients (adjusted HR 0.29; 95%CI 0.10–0.80; p = 0.017) but not the DV1-3 group (HR 0.86; 95%CI 0.40–1.86; p = 0.707) (interaction’s p = 0.087). Conclusion: Our results suggests that DLBCL patients with end-of-treatment PET-CT DV1-3 may not need consolidative RT. Longer follow-up and prospective randomized trials are still necessary to investigate long-term outcomes.

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Validation of deauville score for response evaluation in hodgkin's lymphoma

Cited by 3 publications

References 31 publications

Prognostic value of baseline and interim [18F]FDG PET metabolic parameters in pediatric Hodgkin’s lymphoma

Prognostic value of baseline and interim [18F]FDG PET metabolic parameters in pediatric Hodgkin’s lymphoma

Quantitative Assessment and Predictive Modelling for Treatment Response in Hodgkin's Lymphoma Using 18FDG PET/CT: A Novel Approach

Using Deauville Scoring to Guide Consolidative Radiotherapy in Diffuse Large B-Cell Lymphoma

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