A functional dynamic scoring model to elucidate the significanceof post-induction interim fluorine-18-fluorodeoxyglucose positron emission tomography findings in patients with hodgkin's lymphoma

Eldad J. Dann, Rachel Bar-Shalom, Ada Tamir, Ron Epelbaum, Irit Avivi, Menachem Ben-Shachar, Diana Gaitini, Jacob M. Rowe

Research output: Contribution to journalReview articlepeer-review

Abstract

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 F18FDG 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.

Original languageEnglish
Pages (from-to)1198-1206
Number of pages9
JournalHaematologica
Volume95
Issue number7
DOIs
StatePublished - Jul 2010
Externally publishedYes

Keywords

  • Dynamic score
  • FFDG-PET
  • FDG-PET/CT
  • Hodgkin's lymphoma
  • Prognostic factors
  • Specificity

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