Back to Search
Start Over
An international confirmatory study of the prognostic value of early PET/CT in diffuse large B-cell lymphoma: comparison between Deauville criteria and ΔSUVmax
- Source :
- European Journal of Nuclear Medicine and Molecular Imaging. 40:1312-1320
- Publication Year :
- 2013
- Publisher :
- Springer Science and Business Media LLC, 2013.
-
Abstract
- The role of interim PET/CT in guiding therapeutic strategies in diffuse large B-cell lymphoma (DLBCL) is debated, mainly because interpretation rules vary among centres. This study aimed to explore the reproducibility and confirm the prognostic value of early PET/CT using the Deauville criteria and ΔSUVmax. This international confirmatory study retrospectively evaluated 114 patients with newly diagnosed DLBCL treated with a rituximab-containing regimen. All patients underwent 18F-FDG PET/CT at baseline (PET0) and after two cycles (PET2), with no therapy change based on the latter. Scans were interpreted by three observers using the Deauville five-point scale and ΔSUVmax between PET0 and PET2 was calculated. Interpretations were evaluated for interobserver agreement and for progression-free survival (PFS) prediction. Median follow-up was 39 months. Early PET/CT was predictive of outcome when interpreted with the Deauville criteria and ΔSUVmax. Using the five-point scale, the overall kappa value was 0.66 with the reference background set in the liver (score ≥4) and interobserver agreement was even better using a 66 % ΔSUVmax cut-off (κ = 0.83). Moreover, the prognostic value of interim PET was slightly inferior when using a Deauville score ≥4 than when using a 66 % ΔSUVmax cut-off: for the Deauville score the 3-year PFS estimate was 59 % (45–73 %) in PET2-positive patients vs. 81 % (71–91 %) in PET2-negative patients (P = 0.003); for the 66 % ΔSUVmax cut-off the 3-year PFS estimate was 44 % (23–65 %) in PET2-positive patients vs. 79 % (70–88 %) in PET2-negative patients (P = 0.0002). Although the Deauville criteria are valid for assessing the prognostic value of early PET/CT in DLBCL, computation of the ΔSUVmax leads to better performance and interobserver reproducibility, and should be preferred when a baseline scan is available.
- Subjects :
- Adult
Male
medicine.medical_specialty
Interobserver reproducibility
Newly diagnosed
Multimodal Imaging
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Fluorodeoxyglucose F18
Predictive Value of Tests
medicine
Humans
Radiology, Nuclear Medicine and imaging
Aged
Aged, 80 and over
Observer Variation
PET-CT
Reproducibility
Kappa value
business.industry
General Medicine
Middle Aged
medicine.disease
Interim pet
Regimen
Data Interpretation, Statistical
Positron-Emission Tomography
030220 oncology & carcinogenesis
Female
Lymphoma, Large B-Cell, Diffuse
Radiology
Radiopharmaceuticals
Tomography, X-Ray Computed
business
Nuclear medicine
Diffuse large B-cell lymphoma
Follow-Up Studies
Subjects
Details
- ISSN :
- 16197089 and 16197070
- Volume :
- 40
- Database :
- OpenAIRE
- Journal :
- European Journal of Nuclear Medicine and Molecular Imaging
- Accession number :
- edsair.doi.dedup.....6f4c7bb4fca422b59a58753480033af5