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)

Federico Fallanca, Pierpaolo Alongi, Elena Incerti, Luigi Gianolli, Maria Picchio, Irfan Kayani, Jamshed Bomanji

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate the accuracy and prognostic value of FDG PET/CT for response assessment after treatment in patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) when using the Deauville Criteria (DC) and the International Harmonization Project Criteria (IHPC). Methods: This retrospective study included 101 patients (35 HL, 66 NHL) who underwent early restaging FDG PET/CT after treatment. Scans were evaluated using the IHPC and DC. Two thresholds of positivity for the DC were used: a score of at least 3 (DC3, i.e. scores 3 – 5) and a score of at least 4 (DC4, i.e. a score of 4 or 5). Accuracy was assessed using conventional diagnostic procedures, multidisciplinary team case notes, further PET/CT scans and/or follow-up. Progression-free survival and overall survival were computed using the Kaplan-Meier method. The Cox proportional hazards model was used to identify predictors of outcome. Results: Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FDG PET/CT for early restaging were, respectively, 92 %, 87 %, 74 %, 92 % and 86 % using DC4, 97 %, 76 %, 64 %, 98 % and 84 % using DC3, and 97 %, 67 %, 57 %, 98 % and 76 % using the IHPC. FDG PET/CT positivity was associated with a worse cumulative survival rate over a 2-year period when using DC4 in comparison with the IHPC (20 % vs. 49 %; p <0.05) and DC3 (47 %; p <0.05). Cox regression analysis showed different risks of progression in patients positive on FDG PET/CT using the IHPC, DC3 and DC4 (hazard ratios 1.57, 0.7 and 3.2, respectively). Conclusion: FDG PET/CT using DC4 showed higher diagnostic accuracy for HL and NHL than FDG PET/CT using either the IHPC or DC3, indicating its value in predicting clinical outcome after treatment.
Original languageEnglish
Pages (from-to)1837 - 1848
Number of pages12
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume43
Issue number10
DOIs
Publication statusPublished - Sep 1 2016

Keywords

  • F-FDG PET/CT
  • Deauville Criteria
  • End of therapy
  • Hodgkin lymphoma
  • International Harmonization Project Criteria
  • Non-Hodgkin lymphoma
  • Restaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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