1. Assessment of Waldeyer's ring in pediatric and adolescent Hodgkin lymphoma patients—Importance of multimodality imaging: Results from the EuroNet‐PHL‐C1 trial
- Author
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William Wallace, Andishe Attarbaschi, Dieter Körholz, Lars Kurch, Tanja Pelz, Dirk Vordermark, Walter A. Wohlgemuth, Jonas Karlén, Christian Kunze, Auke Beishuizen, Ana Fernández-Teijeiro, Regine Kluge, Francesco Ceppi, Thomas Walther Georgi, Judith Landman-Parker, Anne Uyttebroeck, Jörg Martin Bartelt, Martha Hoffmann, Dietrich Stoevesandt, Ayca Løndalen, Sebastian Plößl, Michaela Cepelova, Dirk Hasenclever, Andrea Hraskova, Alexander Fosså, Thierry Leblanc, Karin Dieckmann, Jane Pears, C Mauz-Körholz, Dagmar Steiner, Tomasz Klekawka, Gabriele A. Krombach, Stephen Daw, Osama Sabri, and Pediatrics
- Subjects
Male ,Pediatrics ,Multimodal Imaging ,0302 clinical medicine ,Retropharyngeal lymph nodes ,Medicine ,Child ,medicine.diagnostic_test ,Hematology ,Hodgkin Disease ,Magnetic Resonance Imaging ,Oncology ,Positron emission tomography ,Child, Preschool ,030220 oncology & carcinogenesis ,Female ,Radiology ,Life Sciences & Biomedicine ,MRI ,CT ,Waldeyer&apos ,medicine.medical_specialty ,Adolescent ,pediatric Hodgkin lymphoma ,Physical examination ,s ring ,Imaging data ,multimodality imaging ,18F-FDG-PET ,03 medical and health sciences ,Waldeyer's ring ,Fluorodeoxyglucose F18 ,Humans ,ENT investigation ,Neoplasm Staging ,Science & Technology ,business.industry ,Magnetic resonance imaging ,staging ,FDG‐ ,PET ,Positron-Emission Tomography ,Pediatrics, Perinatology and Child Health ,Imaging technology ,F-18‐ ,Hodgkin lymphoma ,Tomography, X-Ray Computed ,business ,030215 immunology - Abstract
BACKGROUND: In the EuroNet Pediatric Hodgkin Lymphoma (EuroNet-PHL) trials, decision on Waldeyer's ring (WR) involvement is usually based on clinical assessment, that is, physical examination and/or nasopharyngoscopy. However, clinical assessment only evaluates mucosal surface and is prone to interobserver variability. Modern cross-sectional imaging technology may provide valuable information beyond mucosal surface, which may lead to a more accurate WR staging. PATIENTS, MATERIALS, AND METHODS: The EuroNet-PHL-C1 trial recruited 2102 patients, of which 1752 underwent central review including reference reading of their cross-sectional imaging data. In 14 of 1752 patients, WR was considered involved according to clinical assessment. In these 14 patients, the WR was re-assessed by applying an imaging-based algorithm considering information from 18 F-fluorodeoxyglucose positron emission tomography, contrast-enhanced computed tomography, and/or magnetic resonance imaging. For verification purposes, the imaging-based algorithm was applied to 100 consecutive patients whose WR was inconspicuous on clinical assessment. RESULTS: The imaging-based algorithm confirmed WR involvement only in four of the 14 patients. Of the remaining 10 patients, four had retropharyngeal lymph node involvement and six an inconspicuous WR. Applying the imaging-based algorithm to 100 consecutive patients with physiological appearance of their WR on clinical assessment, absence of WR involvement could be confirmed in 99. However, suspicion of WR involvement was raised in one patient. CONCLUSIONS: The imaging-based algorithm was feasible and easily applicable at initial staging of young patients with Hodgkin lymphoma. It increased the accuracy of WR staging, which may contribute to a more individualized treatment in the future. ispartof: PEDIATRIC BLOOD & CANCER vol:68 issue:4 ispartof: location:United States status: published
- Published
- 2021