Fused FDG-PET/contrast-enhanced CT detects occult subdiaphragmatic involvement of Hodgkin's lymphoma thereby identifying patients requiring six cycles of anthracycline-containing chemotherapy and consolidation radiation of spleen

M. Picardi, A. Soricelli, F. Grimaldi, E. Nicolai, A. Gallamini, F. Pane

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Spleen and liver assessment for occult involvement of Hodgkin's lymphoma (HL) challenges current staging procedures. Patients and methods: We prospectively evaluated event-free survival (EFS) in 103 HL patients staged with fused 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/contrast-enhanced computed tomography (CT) to identify those at greatest risk for abdominal relapse. The EFS of this series was compared with that of a historical cohort of 100 HL patients staged with separate FDG-PET and diagnostic CT acquisitions. Results: Thirty-one of the 103 patients staged with FDG-PET/contrast-enhanced CT were found to have spleen involvement and 10 patients liver involvement, whereas 14 of the 100 patients staged with separate procedures were found to have spleen involvement and 3 patients liver involvement. There were significantly more intensive treatments (six courses of anthracycline-containing chemotherapy and spleen radiation) in the fused PET/CT group than in the historical cohort (P ≤ 0.04). At a median follow-up of 27 months, five events occurred in the fused PET/CT group (HL relapse, 4 patients; carcinoma, 1 patient) and 19 events in the historical cohort (HL relapse, 18 patients; acute promyelocytic leukemia, 1 patient). Ten of the 18 relapses in the historical cohort were localized in the spleen and/or liver area. None of the four relapses in the fused PET/CT group was localized below the diaphragm. Thus, FDG-PET/contrast-enhanced CT-guided treatment resulted in a 95% EFS, whereas separate FDG-PET and diagnostic CT-guided treatment resulted in an 81% EFS (P = 0.002). Conclusion: FDG-PET/contrast-enhanced CT is an accurate frontline single imaging diagnostic tool enabling effective tailored treatment in HL patients.

Original languageEnglish
Pages (from-to)671-680
Number of pages10
JournalAnnals of Oncology
Volume22
Issue number3
DOIs
Publication statusPublished - Mar 2011

Fingerprint

Consolidation Chemotherapy
Anthracyclines
Deoxyglucose
Hodgkin Disease
Positron-Emission Tomography
Spleen
Tomography
Radiation
Disease-Free Survival
Recurrence
Liver
Acute Promyelocytic Leukemia
Fluorine
Diagnostic Imaging
Therapeutics
Diaphragm

Keywords

  • FDG-PET/contrast-enhanced CT
  • Hodgkin's lymphoma

ASJC Scopus subject areas

  • Oncology
  • Hematology
  • Medicine(all)

Cite this

@article{13a630818aba44819d3710c3bfb9a971,
title = "Fused FDG-PET/contrast-enhanced CT detects occult subdiaphragmatic involvement of Hodgkin's lymphoma thereby identifying patients requiring six cycles of anthracycline-containing chemotherapy and consolidation radiation of spleen",
abstract = "Background: Spleen and liver assessment for occult involvement of Hodgkin's lymphoma (HL) challenges current staging procedures. Patients and methods: We prospectively evaluated event-free survival (EFS) in 103 HL patients staged with fused 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/contrast-enhanced computed tomography (CT) to identify those at greatest risk for abdominal relapse. The EFS of this series was compared with that of a historical cohort of 100 HL patients staged with separate FDG-PET and diagnostic CT acquisitions. Results: Thirty-one of the 103 patients staged with FDG-PET/contrast-enhanced CT were found to have spleen involvement and 10 patients liver involvement, whereas 14 of the 100 patients staged with separate procedures were found to have spleen involvement and 3 patients liver involvement. There were significantly more intensive treatments (six courses of anthracycline-containing chemotherapy and spleen radiation) in the fused PET/CT group than in the historical cohort (P ≤ 0.04). At a median follow-up of 27 months, five events occurred in the fused PET/CT group (HL relapse, 4 patients; carcinoma, 1 patient) and 19 events in the historical cohort (HL relapse, 18 patients; acute promyelocytic leukemia, 1 patient). Ten of the 18 relapses in the historical cohort were localized in the spleen and/or liver area. None of the four relapses in the fused PET/CT group was localized below the diaphragm. Thus, FDG-PET/contrast-enhanced CT-guided treatment resulted in a 95{\%} EFS, whereas separate FDG-PET and diagnostic CT-guided treatment resulted in an 81{\%} EFS (P = 0.002). Conclusion: FDG-PET/contrast-enhanced CT is an accurate frontline single imaging diagnostic tool enabling effective tailored treatment in HL patients.",
keywords = "FDG-PET/contrast-enhanced CT, Hodgkin's lymphoma",
author = "M. Picardi and A. Soricelli and F. Grimaldi and E. Nicolai and A. Gallamini and F. Pane",
year = "2011",
month = "3",
doi = "10.1093/annonc/mdq403",
language = "English",
volume = "22",
pages = "671--680",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "NLM (Medline)",
number = "3",

}

TY - JOUR

T1 - Fused FDG-PET/contrast-enhanced CT detects occult subdiaphragmatic involvement of Hodgkin's lymphoma thereby identifying patients requiring six cycles of anthracycline-containing chemotherapy and consolidation radiation of spleen

AU - Picardi, M.

AU - Soricelli, A.

AU - Grimaldi, F.

AU - Nicolai, E.

AU - Gallamini, A.

AU - Pane, F.

PY - 2011/3

Y1 - 2011/3

N2 - Background: Spleen and liver assessment for occult involvement of Hodgkin's lymphoma (HL) challenges current staging procedures. Patients and methods: We prospectively evaluated event-free survival (EFS) in 103 HL patients staged with fused 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/contrast-enhanced computed tomography (CT) to identify those at greatest risk for abdominal relapse. The EFS of this series was compared with that of a historical cohort of 100 HL patients staged with separate FDG-PET and diagnostic CT acquisitions. Results: Thirty-one of the 103 patients staged with FDG-PET/contrast-enhanced CT were found to have spleen involvement and 10 patients liver involvement, whereas 14 of the 100 patients staged with separate procedures were found to have spleen involvement and 3 patients liver involvement. There were significantly more intensive treatments (six courses of anthracycline-containing chemotherapy and spleen radiation) in the fused PET/CT group than in the historical cohort (P ≤ 0.04). At a median follow-up of 27 months, five events occurred in the fused PET/CT group (HL relapse, 4 patients; carcinoma, 1 patient) and 19 events in the historical cohort (HL relapse, 18 patients; acute promyelocytic leukemia, 1 patient). Ten of the 18 relapses in the historical cohort were localized in the spleen and/or liver area. None of the four relapses in the fused PET/CT group was localized below the diaphragm. Thus, FDG-PET/contrast-enhanced CT-guided treatment resulted in a 95% EFS, whereas separate FDG-PET and diagnostic CT-guided treatment resulted in an 81% EFS (P = 0.002). Conclusion: FDG-PET/contrast-enhanced CT is an accurate frontline single imaging diagnostic tool enabling effective tailored treatment in HL patients.

AB - Background: Spleen and liver assessment for occult involvement of Hodgkin's lymphoma (HL) challenges current staging procedures. Patients and methods: We prospectively evaluated event-free survival (EFS) in 103 HL patients staged with fused 2-[fluorine-18]fluoro-2-deoxy-D-glucose-positron emission tomography (FDG-PET)/contrast-enhanced computed tomography (CT) to identify those at greatest risk for abdominal relapse. The EFS of this series was compared with that of a historical cohort of 100 HL patients staged with separate FDG-PET and diagnostic CT acquisitions. Results: Thirty-one of the 103 patients staged with FDG-PET/contrast-enhanced CT were found to have spleen involvement and 10 patients liver involvement, whereas 14 of the 100 patients staged with separate procedures were found to have spleen involvement and 3 patients liver involvement. There were significantly more intensive treatments (six courses of anthracycline-containing chemotherapy and spleen radiation) in the fused PET/CT group than in the historical cohort (P ≤ 0.04). At a median follow-up of 27 months, five events occurred in the fused PET/CT group (HL relapse, 4 patients; carcinoma, 1 patient) and 19 events in the historical cohort (HL relapse, 18 patients; acute promyelocytic leukemia, 1 patient). Ten of the 18 relapses in the historical cohort were localized in the spleen and/or liver area. None of the four relapses in the fused PET/CT group was localized below the diaphragm. Thus, FDG-PET/contrast-enhanced CT-guided treatment resulted in a 95% EFS, whereas separate FDG-PET and diagnostic CT-guided treatment resulted in an 81% EFS (P = 0.002). Conclusion: FDG-PET/contrast-enhanced CT is an accurate frontline single imaging diagnostic tool enabling effective tailored treatment in HL patients.

KW - FDG-PET/contrast-enhanced CT

KW - Hodgkin's lymphoma

UR - http://www.scopus.com/inward/record.url?scp=79952015764&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79952015764&partnerID=8YFLogxK

U2 - 10.1093/annonc/mdq403

DO - 10.1093/annonc/mdq403

M3 - Article

VL - 22

SP - 671

EP - 680

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 3

ER -