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Residual SUVmax in FDG-PET/CT Evaluation after First-Line Treatment in Aggressive B-Cell Non-Hodgkin's and Hodgkin's Lymphoma

Yıl 2019, Cilt: 45 Sayı: 1, 5 - 11, 01.04.2019
https://doi.org/10.32708/uutfd.464814

Öz











The
purpose of this study was to assess the sensitivity and specificity of
fluorine-18 fluorodeoxyglucose positron emission tomography/ computed
tomography (FDG-PET/CT) according to the residual SUVmax value in
patients with lymphoma after firstline therapy using clinical follow-up or the biopsy
results, retrospectively. Total 69 patients diagnosed with aggressive B-cell
non-Hodgkin's lymphoma (high grade unclassified B-cell lymphoma, diffuse large
B-cell lymphoma [DLBCL], mantle-cell lymphoma, Burkitt's lymphoma) and
Hodgkin's lymphoma (classic and nodular predominant) who were clinically
followed up between January 2004 - May 2012 and older than 18 were included in
the study. The median follow-up time was 40 months and the mean age was 49.7 ±
15.5 years in patients whose end-of-treatment FDG-PET / CT were assessed. Only
one of the 23 patients with Hodgkin's lymphoma and 10 (21%) of the 46
non-Hodgkin's lymphoma patients were relapsed after the standard therapy in
clinical follow-up. 7 (15%) non-Hodgkin's lymphoma patients were resistant to
the therapy. Median time to relapse of the patients was 20 months. Sensitivity,
specificity, positive predictive value, negative predictive value, and accuracy
rates were calculated as 66.6%, 94.1%, 80%, 88.9%, 87%, respectively when the
residual SUVmax cut-off value > 3.5 was accepted. In conclusion; residual
SUVmax cut-off value > 3,5 has the highest accuracy
in the end-of-treatment FDG-PET/CT
similar to the Gallamini criteria. It was thought that SUVmax cut-off value
> 4 which has 96% specificity in ROC analyzes also could be used in
lymphomas which has a suspicious visual assessment.

Kaynakça

  • Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography (PET) for response assessment of lymphoma: consensus of the imaging Subcommittee of International Harmonization Project (IHP) in lymphoma. J Clin Oncol 2007; 25: 571- 8.
  • Cheson BD, Horning SJ, Coiffier B, et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999; 17: 1244- 53
  • Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007; 25: 579- 86.
  • Meignan M, Gallamini A, Haioun C. Report on the First International Workshop on Interim-PET-Scan in Lymphoma. Leuk Lymphoma 2009; 50: 257- 60.
  • Biggi A, Bergesio F, Chauvie S. Monitoring response in lymphomas: qualitative, quantitative, or what else?. Leuk Lymphoma 2018 Jul 22: 1- 7 (Baskıda).
  • Hoekstra CJ, Paglianiti I, Hoekstra OS, Smit EF, Postmus PE, Teule GJ, Lammertsma AA. Monitoring response to therapy in cancer using [18F]-2-fluoro-2-deoxy-D-glucose and positron emission tomography: an overview of different analytical methods. Eur J Nucl Med 2000;27: 731–43.
  • Ur Metser, Ravi Mohan, Vaughan Beckley, Hadas Moshonov, David Hodgson, Grainne Murphy. FDG PET/CT Response Assessment Criteria for Patients with Hodgkin’s and Non-Hodgkin’s Lymphoma at End of Therapy: A Multiparametric Approach. Nucl Med Mol Imaging 2016; 50: 46– 53.
  • Gallamini A, Hutchings M, Rigacci L, et al. Early interim 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced stage Hodgkin’s lymphoma: a report from a joint Italian-Danish study. J Clin Oncol 2007; 25: 3746-52.
  • Manohar K, Bhagwant RM, Raja S, Bhattacharya A, Malhotra P, Varma S. Comparison of various criteria in interpreting end of therapy F-18 labeled fluorodeoxyglucose positron emission tomography/computed tomography in patients with aggressive non-Hodgkin lymphoma. Leuk Lymphoma 2013; 54 : 714– 9.
  • Biggi A, Gallamini A, Chauvie S, et al. International validation study for interim PET in ABVD treated, advanced stage Hodgkin lymphoma: interpretation criteria and concordance rate among reviewers. J Nucl Med. 2013; 54: 683– 90.
  • Naumann R, Vaic A, Beuthien-Baumann B, Bredow J, Kropp J, Kittner T, Franke WG, Ehninger G. Prognostic value of positron emission tomography in the evaluation of post-treatment residual mass in patients with Hodgkin’s disease and non Hodgkin’s lymphoma. Br J Haematol 2001; 115: 793- 800.
  • Lin C, Itti E, Haioun C, Petegnief Y, Luciani A, Dupuis J, Paone G, Talbot JN, Rahmouni A, Meignan M. Early 18F-FDG PET for prediction of prognosis in patients with diffuse large B-cell lymphoma: SUV-based assessment versus visual analysis. J Nucl Med 2007; 48: 1626-32.
  • Freudenberg LS, Antoch G, Schutt P, et al: FDG-PET/CT in re-staging of patients with lymphoma. Eur J Nucl Med Mol Imaging 2004; 31: 325- 9.
  • Itti E, Lin C, Dupuis J, Paone G, Capacchione D, Rahmouni A, Haioun C, Meignan M. Prognostic value of interim 18F-FDG PET in patients with diffuse large B-cell lymphoma: SUV-based assessment at 4 cycles of chemotherapy. J Nucl Med 2009; 50: 527- 33.
  • Brepoels L, Stroobants S, De Wever W, et al. Hodgkin lymphoma: Response assessment by revised International Workshop Criteria. Leuk Lymphoma 2007; 48: 1539- 47.
  • Brepoels L, Stroobants S, De Wever W, et al. Aggressive and indolent non- Hodgkin’s lymphoma: response assessment by integrated International Workshop Criteria. Leuk Lymphoma 2007; 48: 1522- 30.
  • Le Roux PY, Gastinne T, Le Gouill S, et al. Prognostic value of interim FDG PET/CT in Hodgkin’s lymphoma patients treated with interim response-adapted strategy: comparison of International Harmonization Project (IHP), Gallamini and London criteria. Eur J Nucl Med Mol Imaging (2011) 38: 1064- 71.
  • Schaefer NG, Taverna C, Strobel K, Wastl C, Kurrer M, Hany TF. Hodgkin disease: diagnostic value of FDG PET/CT after first-line therapy-is biopsy of FDG-avid lesions still needed?. Radiology 2007; 244: 257- 62.
  • Cerci JJ, Trindade E, Pracchia LF, et al. Cost effectiveness of positron emission tomography in patients with Hodgkin’s lmphoma in unconfirmed complete remission or partial remission after first-line therapy. J Clin Oncol 2010; 28: 1415- 21.
  • Kajárya K, Molnár Z, Györke T, Szakáll S Jr, Molnár P, Lengyel Z. Comparison of the International Harmonization Project, London and Gallamini criteria in the interpretation of 18F-FDG PET/CT examinations after first-line treatment in Hodgkin’s lymphoma. Nucl Med Commun 2014; 35(2): 169-75.
  • Fallanca F, Alongi P, Incerti E, et al. Diagnostic accuracy of FDG PET/CT for clinical evaluation at the end of treatment of HL and NHL: a comparison of the Deauville Criteria (DC) and the International Harmonization Project Criteria (IHPC). Eur J Nucl Med Mol Imaging 2016; 43(10): 1837- 48.
  • Metser U, Mohan R, Beckley V, Moshonov H, Hodgson D, Murphy G. FDG PET/CT Response Assessment Criteria for Patients with Hodgkin’s and Non-Hodgkin’s Lymphoma at End of Therapy: A Multiparametric Approach. Nucl Med Mol Imaging 2016; 50: 46- 53.

Agresif B hücreli Hodgkin Dışı ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT ile Değerlendirilmesinde Rezidüel SUVmax

Yıl 2019, Cilt: 45 Sayı: 1, 5 - 11, 01.04.2019
https://doi.org/10.32708/uutfd.464814

Öz











Bu çalışmada; lenfomada ilk
basamak tedavi sonrasında Flor-18 fluorodeoksiglukoz pozitron emisyon
tomografisinin (FDG-PET/BT) rezidüel SUVmax değerine göre duyarlılık
ve özgünlüğünün geriye dönük olarak klinik takip veya biyopsi sonuçları
doğrultusunda belirlenmesi amaçlandı. Çalışmaya Ocak 2004-Mayıs 2012 tarihleri
arasında takip edilen, 18 yaş üzeri, agresif B hücreli Hodgkin dışı lenfoma
(Yüksek dereceli sınıflandırılamamış B hücreli lenfoma, diffüz büyük B hücreli
lenfoma [DBBHL], mantle hücreli lenfoma, Burkitt lenfoma) ve Hodgkin lenfoma
(klasik ve nodüler predominant) tanılı 69 hasta dahil edildi. Tedavi sonu
FDG-PET/BT’ leri değerlendirilen hastaların ortanca takip süresi 40 ay olup ortalama
yaş 49,7 ± 15,5  yıl olarak hesaplandı. Klinik
takipte standart tedavi sonrası 23 Hodgkin lenfoma olgusunun sadece birinde, 46
Hodgkin dışı lenfoma olgusunun 10’ unda (%21) relaps gözlendi. Hodgkin dışı
lenfomalı 7 olgu (%15) ise tedaviye dirençli idi. Hastaların ortanca relaps
süresi 20 ay idi. Rezidü SUVmax > 3,5 kabul edildiğinde duyarlılık,
özgüllük, olumlu öngörü, olumsuz öngörü, doğruluk oranları sırası ile %66,6, %94,1,
%80, %88,9, %87 olarak hesaplandı. Sonuç olarak; Gallamini kriterleri ile
benzer şekilde tedavi sonu FDG-PET/BT’ deki en yüksek doğruluğa sahip rezidüel
SUVmax sınır değerinin >3,5 olduğu saptandı. ROC analizlerinde ise
SUVmax
>4 değerinin %96 özgüllüğe sahip olduğu ve görsel
değerlendirmenin şüpheli olduğu lenfomalarda bu sınır değerin anlamlı
olabileceği düşünüldü. 

Kaynakça

  • Juweid ME, Stroobants S, Hoekstra OS, et al. Use of positron emission tomography (PET) for response assessment of lymphoma: consensus of the imaging Subcommittee of International Harmonization Project (IHP) in lymphoma. J Clin Oncol 2007; 25: 571- 8.
  • Cheson BD, Horning SJ, Coiffier B, et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999; 17: 1244- 53
  • Cheson BD, Pfistner B, Juweid ME, et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007; 25: 579- 86.
  • Meignan M, Gallamini A, Haioun C. Report on the First International Workshop on Interim-PET-Scan in Lymphoma. Leuk Lymphoma 2009; 50: 257- 60.
  • Biggi A, Bergesio F, Chauvie S. Monitoring response in lymphomas: qualitative, quantitative, or what else?. Leuk Lymphoma 2018 Jul 22: 1- 7 (Baskıda).
  • Hoekstra CJ, Paglianiti I, Hoekstra OS, Smit EF, Postmus PE, Teule GJ, Lammertsma AA. Monitoring response to therapy in cancer using [18F]-2-fluoro-2-deoxy-D-glucose and positron emission tomography: an overview of different analytical methods. Eur J Nucl Med 2000;27: 731–43.
  • Ur Metser, Ravi Mohan, Vaughan Beckley, Hadas Moshonov, David Hodgson, Grainne Murphy. FDG PET/CT Response Assessment Criteria for Patients with Hodgkin’s and Non-Hodgkin’s Lymphoma at End of Therapy: A Multiparametric Approach. Nucl Med Mol Imaging 2016; 50: 46– 53.
  • Gallamini A, Hutchings M, Rigacci L, et al. Early interim 2-[18F] fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced stage Hodgkin’s lymphoma: a report from a joint Italian-Danish study. J Clin Oncol 2007; 25: 3746-52.
  • Manohar K, Bhagwant RM, Raja S, Bhattacharya A, Malhotra P, Varma S. Comparison of various criteria in interpreting end of therapy F-18 labeled fluorodeoxyglucose positron emission tomography/computed tomography in patients with aggressive non-Hodgkin lymphoma. Leuk Lymphoma 2013; 54 : 714– 9.
  • Biggi A, Gallamini A, Chauvie S, et al. International validation study for interim PET in ABVD treated, advanced stage Hodgkin lymphoma: interpretation criteria and concordance rate among reviewers. J Nucl Med. 2013; 54: 683– 90.
  • Naumann R, Vaic A, Beuthien-Baumann B, Bredow J, Kropp J, Kittner T, Franke WG, Ehninger G. Prognostic value of positron emission tomography in the evaluation of post-treatment residual mass in patients with Hodgkin’s disease and non Hodgkin’s lymphoma. Br J Haematol 2001; 115: 793- 800.
  • Lin C, Itti E, Haioun C, Petegnief Y, Luciani A, Dupuis J, Paone G, Talbot JN, Rahmouni A, Meignan M. Early 18F-FDG PET for prediction of prognosis in patients with diffuse large B-cell lymphoma: SUV-based assessment versus visual analysis. J Nucl Med 2007; 48: 1626-32.
  • Freudenberg LS, Antoch G, Schutt P, et al: FDG-PET/CT in re-staging of patients with lymphoma. Eur J Nucl Med Mol Imaging 2004; 31: 325- 9.
  • Itti E, Lin C, Dupuis J, Paone G, Capacchione D, Rahmouni A, Haioun C, Meignan M. Prognostic value of interim 18F-FDG PET in patients with diffuse large B-cell lymphoma: SUV-based assessment at 4 cycles of chemotherapy. J Nucl Med 2009; 50: 527- 33.
  • Brepoels L, Stroobants S, De Wever W, et al. Hodgkin lymphoma: Response assessment by revised International Workshop Criteria. Leuk Lymphoma 2007; 48: 1539- 47.
  • Brepoels L, Stroobants S, De Wever W, et al. Aggressive and indolent non- Hodgkin’s lymphoma: response assessment by integrated International Workshop Criteria. Leuk Lymphoma 2007; 48: 1522- 30.
  • Le Roux PY, Gastinne T, Le Gouill S, et al. Prognostic value of interim FDG PET/CT in Hodgkin’s lymphoma patients treated with interim response-adapted strategy: comparison of International Harmonization Project (IHP), Gallamini and London criteria. Eur J Nucl Med Mol Imaging (2011) 38: 1064- 71.
  • Schaefer NG, Taverna C, Strobel K, Wastl C, Kurrer M, Hany TF. Hodgkin disease: diagnostic value of FDG PET/CT after first-line therapy-is biopsy of FDG-avid lesions still needed?. Radiology 2007; 244: 257- 62.
  • Cerci JJ, Trindade E, Pracchia LF, et al. Cost effectiveness of positron emission tomography in patients with Hodgkin’s lmphoma in unconfirmed complete remission or partial remission after first-line therapy. J Clin Oncol 2010; 28: 1415- 21.
  • Kajárya K, Molnár Z, Györke T, Szakáll S Jr, Molnár P, Lengyel Z. Comparison of the International Harmonization Project, London and Gallamini criteria in the interpretation of 18F-FDG PET/CT examinations after first-line treatment in Hodgkin’s lymphoma. Nucl Med Commun 2014; 35(2): 169-75.
  • Fallanca F, Alongi P, Incerti E, et al. Diagnostic accuracy of FDG PET/CT for clinical evaluation at the end of treatment of HL and NHL: a comparison of the Deauville Criteria (DC) and the International Harmonization Project Criteria (IHPC). Eur J Nucl Med Mol Imaging 2016; 43(10): 1837- 48.
  • Metser U, Mohan R, Beckley V, Moshonov H, Hodgson D, Murphy G. FDG PET/CT Response Assessment Criteria for Patients with Hodgkin’s and Non-Hodgkin’s Lymphoma at End of Therapy: A Multiparametric Approach. Nucl Med Mol Imaging 2016; 50: 46- 53.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Özgün Araştırma Makaleleri
Yazarlar

Celal Acar 0000-0002-5184-1219

Vildan Özkocaman

Ali Tayyar Akpınar Bu kişi benim

Fahir Özkalemkaş

Yayımlanma Tarihi 1 Nisan 2019
Kabul Tarihi 28 Kasım 2018
Yayımlandığı Sayı Yıl 2019 Cilt: 45 Sayı: 1

Kaynak Göster

APA Acar, C., Özkocaman, V., Akpınar, A. T., Özkalemkaş, F. (2019). Agresif B hücreli Hodgkin Dışı ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT ile Değerlendirilmesinde Rezidüel SUVmax. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 45(1), 5-11. https://doi.org/10.32708/uutfd.464814
AMA Acar C, Özkocaman V, Akpınar AT, Özkalemkaş F. Agresif B hücreli Hodgkin Dışı ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT ile Değerlendirilmesinde Rezidüel SUVmax. Uludağ Tıp Derg. Nisan 2019;45(1):5-11. doi:10.32708/uutfd.464814
Chicago Acar, Celal, Vildan Özkocaman, Ali Tayyar Akpınar, ve Fahir Özkalemkaş. “Agresif B hücreli Hodgkin Dışı Ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT Ile Değerlendirilmesinde Rezidüel SUVmax”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45, sy. 1 (Nisan 2019): 5-11. https://doi.org/10.32708/uutfd.464814.
EndNote Acar C, Özkocaman V, Akpınar AT, Özkalemkaş F (01 Nisan 2019) Agresif B hücreli Hodgkin Dışı ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT ile Değerlendirilmesinde Rezidüel SUVmax. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45 1 5–11.
IEEE C. Acar, V. Özkocaman, A. T. Akpınar, ve F. Özkalemkaş, “Agresif B hücreli Hodgkin Dışı ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT ile Değerlendirilmesinde Rezidüel SUVmax”, Uludağ Tıp Derg, c. 45, sy. 1, ss. 5–11, 2019, doi: 10.32708/uutfd.464814.
ISNAD Acar, Celal vd. “Agresif B hücreli Hodgkin Dışı Ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT Ile Değerlendirilmesinde Rezidüel SUVmax”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 45/1 (Nisan 2019), 5-11. https://doi.org/10.32708/uutfd.464814.
JAMA Acar C, Özkocaman V, Akpınar AT, Özkalemkaş F. Agresif B hücreli Hodgkin Dışı ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT ile Değerlendirilmesinde Rezidüel SUVmax. Uludağ Tıp Derg. 2019;45:5–11.
MLA Acar, Celal vd. “Agresif B hücreli Hodgkin Dışı Ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT Ile Değerlendirilmesinde Rezidüel SUVmax”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, c. 45, sy. 1, 2019, ss. 5-11, doi:10.32708/uutfd.464814.
Vancouver Acar C, Özkocaman V, Akpınar AT, Özkalemkaş F. Agresif B hücreli Hodgkin Dışı ve Hodgkin Lenfomada İlk Basamak Tedavi Yanıtının FDG-PET/BT ile Değerlendirilmesinde Rezidüel SUVmax. Uludağ Tıp Derg. 2019;45(1):5-11.

ISSN: 1300-414X, e-ISSN: 2645-9027

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