BACKGROUND: The findings of interim fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) predict progression-free survival of patients with Hodgkin's lymphoma. Historically, the assessment was based on a static all-or-none scoring system. However, the clinical significance of any positivity in interim FDG-PET/CT has not been defined. DESIGN AND METHODS: Ninety-six patients with Hodgkin's lymphoma who underwent interim FDG-PET/CT were evaluated using dynamic and visual scores, employing mediastinal or liver blood pool uptake as a comparator. FDG-PET/CT was prospectively defined as positive if any abnormal F(18)FDG uptake was present. In a retrospective analysis dynamic score 0 indicated resolution of all disease sites; score 1 defined a single residual focus; score 2 denoted a reduction in the number of foci; score 3 defined a reduction in intensity with no reduction in number; and score 4 indicated no change in the number and intensity of foci or appearance of new foci. RESULTS: The dynamic visual score review reduced the number of positive interim studies from 24 to 6 if a score of 2 or less was considered negative, with significantly better specificity (96%) as compared to static visual scores (78%-86%). The 5-year progression-free survival and overall survival rates in patients who had a negative dynamic score were 92% and 97%, respectively; the corresponding figures for patients with positive results were 50% and 67%. CONCLUSIONS: A dynamic visual score may be a better indicator for tailoring therapy than static visual scoring.
BACKGROUND: The findings of interim fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) predict progression-free survival of patients with Hodgkin's lymphoma. Historically, the assessment was based on a static all-or-none scoring system. However, the clinical significance of any positivity in interim FDG-PET/CT has not been defined. DESIGN AND METHODS: Ninety-six patients with Hodgkin's lymphoma who underwent interim FDG-PET/CT were evaluated using dynamic and visual scores, employing mediastinal or liver blood pool uptake as a comparator. FDG-PET/CT was prospectively defined as positive if any abnormal F(18)FDG uptake was present. In a retrospective analysis dynamic score 0 indicated resolution of all disease sites; score 1 defined a single residual focus; score 2 denoted a reduction in the number of foci; score 3 defined a reduction in intensity with no reduction in number; and score 4 indicated no change in the number and intensity of foci or appearance of new foci. RESULTS: The dynamic visual score review reduced the number of positive interim studies from 24 to 6 if a score of 2 or less was considered negative, with significantly better specificity (96%) as compared to static visual scores (78%-86%). The 5-year progression-free survival and overall survival rates in patients who had a negative dynamic score were 92% and 97%, respectively; the corresponding figures for patients with positive results were 50% and 67%. CONCLUSIONS: A dynamic visual score may be a better indicator for tailoring therapy than static visual scoring.
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Authors: Lalitha K Shankar; John M Hoffman; Steve Bacharach; Michael M Graham; Joel Karp; Adriaan A Lammertsma; Steven Larson; David A Mankoff; Barry A Siegel; Annick Van den Abbeele; Jeffrey Yap; Daniel Sullivan Journal: J Nucl Med Date: 2006-06 Impact factor: 10.057
Authors: Bruce D Cheson; Beate Pfistner; Malik E Juweid; Randy D Gascoyne; Lena Specht; Sandra J Horning; Bertrand Coiffier; Richard I Fisher; Anton Hagenbeek; Emanuele Zucca; Steven T Rosen; Sigrid Stroobants; T Andrew Lister; Richard T Hoppe; Martin Dreyling; Kensei Tobinai; Julie M Vose; Joseph M Connors; Massimo Federico; Volker Diehl Journal: J Clin Oncol Date: 2007-01-22 Impact factor: 44.544
Authors: Malik E Juweid; Sigrid Stroobants; Otto S Hoekstra; Felix M Mottaghy; Markus Dietlein; Ali Guermazi; Gregory A Wiseman; Lale Kostakoglu; Klemens Scheidhauer; Andreas Buck; Ralph Naumann; Karoline Spaepen; Rodney J Hicks; Wolfgang A Weber; Sven N Reske; Markus Schwaiger; Lawrence H Schwartz; Josee M Zijlstra; Barry A Siegel; Bruce D Cheson Journal: J Clin Oncol Date: 2007-01-22 Impact factor: 44.544
Authors: Wouter J Plattel; Anke van den Berg; Lydia Visser; Anne-Marijn van der Graaf; Jan Pruim; Hans Vos; Bouke Hepkema; Arjan Diepstra; Gustaaf W van Imhoff Journal: Haematologica Date: 2011-11-04 Impact factor: 9.941
Authors: Stephanus T Malherbe; Shubhada Shenai; Katharina Ronacher; Andre G Loxton; Gregory Dolganov; Magdalena Kriel; Tran Van; Ray Y Chen; James Warwick; Laura E Via; Taeksun Song; Myungsun Lee; Gary Schoolnik; Gerard Tromp; David Alland; Clifton E Barry; Jill Winter; Gerhard Walzl; Lance Lucas; Gian van der Spuy; Kim Stanley; Lani Thiart; Bronwyn Smith; Nelita Du Plessis; Caroline G G Beltran; Elizna Maasdorp; Annare Ellmann; Hongjo Choi; Joonsung Joh; Lori E Dodd; Brian Allwood; Coenie Koegelenberg; Morné Vorster; Stephanie Griffith-Richards Journal: Nat Med Date: 2016-09-05 Impact factor: 53.440
Authors: Stephanus T Malherbe; Patrick Dupont; Ilse Kant; Petri Ahlers; Magdalena Kriel; André G Loxton; Ray Y Chen; Laura E Via; Friedrich Thienemann; Robert J Wilkinson; Clifton E Barry; Stephanie Griffith-Richards; Annare Ellman; Katharina Ronacher; Jill Winter; Gerhard Walzl; James M Warwick Journal: EJNMMI Res Date: 2018-06-25 Impact factor: 3.138