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Only strongly enhanced residual FDG uptake in early response PET (Deauville 5 or qPET ≥ 2) is prognostic in pediatric Hodgkin lymphoma: Results of the GPOH‐HD2002 trial
Author(s) -
Kurch L.,
Hasenclever D.,
Kluge R.,
Georgi T.,
Tchavdarova L.,
Golombeck M.,
Sabri O.,
Eggert A.,
Brenner W.,
Sykora K.W.,
Bengel F.M.,
Rossig C.,
Körholz D.,
Schäfers M.,
Feuchtinger T.,
Bartenstein P.,
Ammann R.A.,
Krause T.,
Urban C.,
Aigner R.,
Gattenlöhner S.,
Klapper W.,
MauzKörholz C.
Publication year - 2019
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27539
Subject(s) - medicine , positron emission tomography , nuclear medicine , fluorodeoxyglucose , lymphoma , standardized uptake value , predictive value , chemotherapy , pet imaging , oncology , radiology
Abstract Purpose In 2014, we published the qPET method to quantify fluorodeoxyglucose positron emission tomography (FDG‐PET) responses. Analysis of the distribution of the quantified signals suggested that a clearly abnormal FDG‐PET response corresponds to a visual Deauville score (vDS) of 5 and high qPET values ≥ 2. Evaluation in long‐term outcome data is still pending. Therefore, we analyzed progression‐free survival (PFS) by early FDG‐PET response in a subset of the GPOH‐HD2002 trial for pediatric Hodgkin lymphoma (PHL). Patients/Methods Pairwise FDG‐PET scans for initial staging and early response assessment after two cycles of chemotherapy were available in 93 PHL patients. vDS and qPET measurement were performed and related to PFS. Results Patients with a qPET value ≥ 2.0 or vDS of 5 had 5‐year PFS rates of 44%, respectively 50%. Those with qPET values < 2.0 or vDS 1 to 4 had 5‐year PFS rates of 90%, respectively 80%. The positive predictive value of FDG‐PET response assessment increased from 18% (9%; 33%) using a qPET threshold of 0.95 (vDS ≤ 3) to 30% (13%; 54%) for a qPET threshold of 1.3 (vDS ≤ 4) and to 56% (23%; 85%) when the qPET threshold was ≥ 2.0 (vDS 5). The negative predictive values remained stable at ≥92% (CI: 82%; 98%). Conclusion Only strongly enhanced residual FDG uptake in early response PET (vDS 5 or qPET ≥ 2, respectively) seems to be markedly prognostic in PHL when treatment according to the GPOH‐HD‐2002 protocol is given.