PURPOSE: In adult Hodgkin's lymphoma (HL) risk stratification after early therapy response assessment with [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) seems to allow tailoring therapy with less toxicity for patients with adequate metabolic response. This study delivers the first prospective data on the potential of FDG-PET for response assessment in pediatric HL. PATIENTS AND METHODS: FDG-PET was performed in 40 pediatric HL patients before polychemotherapy (PET-1), after two cycles of polychemotherapy (PET-2), and after completion of polychemotherapy (PET-3). Mean follow-up was 46 months (range, 26 to 72 months). RESULTS: At early and late response assessment, the proportion of PET-negative patients was significantly higher compared with those patients with negative findings in conventional imaging methods (CIMs; PET-2, 26 of 40 v CIM-2, one of 40; P < .001; PET-3, 21 of 29 v CIM-3, four of 29; P < .001). Sensitivity and negative predictive value were 100% for early and late therapy response assessment by PET. Both patients suffering a relapse during follow-up were identified by PET-2/3, whereas one of these patients was not detected by CIM-3. PET was superior to CIMs with regard to specificity in early and late therapy response assessment (68% v 3%, and 78% v 11%, respectively; both P < .001). Specificity of early therapy response assessment by PET was improved to 97% by quantitative analysis of maximal standardized uptake value reduction using a cutoff value of 58%. CONCLUSION: Pediatric HL patients with a negative PET in response assessment have an excellent prognosis while PET-positive patients have an increased risk for relapse.
PURPOSE: In adult Hodgkin's lymphoma (HL) risk stratification after early therapy response assessment with [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET) seems to allow tailoring therapy with less toxicity for patients with adequate metabolic response. This study delivers the first prospective data on the potential of FDG-PET for response assessment in pediatric HL. PATIENTS AND METHODS: FDG-PET was performed in 40 pediatric HL patients before polychemotherapy (PET-1), after two cycles of polychemotherapy (PET-2), and after completion of polychemotherapy (PET-3). Mean follow-up was 46 months (range, 26 to 72 months). RESULTS: At early and late response assessment, the proportion of PET-negative patients was significantly higher compared with those patients with negative findings in conventional imaging methods (CIMs; PET-2, 26 of 40 v CIM-2, one of 40; P < .001; PET-3, 21 of 29 v CIM-3, four of 29; P < .001). Sensitivity and negative predictive value were 100% for early and late therapy response assessment by PET. Both patients suffering a relapse during follow-up were identified by PET-2/3, whereas one of these patients was not detected by CIM-3. PET was superior to CIMs with regard to specificity in early and late therapy response assessment (68% v 3%, and 78% v 11%, respectively; both P < .001). Specificity of early therapy response assessment by PET was improved to 97% by quantitative analysis of maximal standardized uptake value reduction using a cutoff value of 58%. CONCLUSION: Pediatric HL patients with a negative PET in response assessment have an excellent prognosis while PET-positive patients have an increased risk for relapse.
Authors: Stephan D Voss; Lu Chen; Louis S Constine; Allen Chauvenet; Thomas J Fitzgerald; Sue C Kaste; Thomas Slovis; Cindy L Schwartz Journal: J Clin Oncol Date: 2012-06-11 Impact factor: 44.544
Authors: Peter D Cole; Kathleen M McCarten; Richard A Drachtman; Pedro de Alarcon; Lu Chen; Tanya M Trippett; Cindy L Schwartz Journal: Pediatr Hematol Oncol Date: 2010-11 Impact factor: 1.969
Authors: Ashok J Theruvath; Florian Siedek; Anne M Muehe; Jordi Garcia-Diaz; Julian Kirchner; Ole Martin; Michael P Link; Sheri Spunt; Allison Pribnow; Jarrett Rosenberg; Ken Herrmann; Sergios Gatidis; Jürgen F Schäfer; Michael Moseley; Lale Umutlu; Heike E Daldrup-Link Journal: Radiology Date: 2020-05-05 Impact factor: 11.105
Authors: Thomas C Kwee; Taro Takahara; Malou A Vermoolen; Marc B Bierings; Willem P Mali; Rutger A J Nievelstein Journal: Pediatr Radiol Date: 2010-07-30