Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jul;95(7):1198-206.
doi: 10.3324/haematol.2009.016105. Epub 2010 Apr 21.

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

Eldad J Dann  1 , Rachel Bar-Shalom, Ada Tamir, Ron Epelbaum, Irit Avivi, Menachem Ben-Shachar, Diana Gaitini, Jacob M Rowe
Affiliations

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

Eldad J Dann et al. Haematologica. 2010 Jul.

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 F(18)FDG 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.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
(A) Clinical outcome according to initial therapy protocol and interim FDG-PET/CT results using the binary visual score (B). Clinical outcome according to initial therapy protocol and interim FDG-PET/CT results using the dynamic visual score.
Figure 2.
Figure 2.
Five-year progression-free survival (A) and overall survival (B) of patients with positive (n=24) and negative (n=72) interim FDG PET/CT using the binary visual score.
Figure 3.
Figure 3.
Five-year progression-free survival (A) and overall survival (B) of patients with positive (n=6) and negative (n=90) interim FDG PET/CT using the dynamic visual score.
Figure 4.
Figure 4.
Five-year progression-free survival of patients with positive and negative interim FDG PET/CT using the mediastinal blood pool uptake (A) and liver blood pool uptake (B) as comparators.
See this image and copyright information in PMC

References

    1. Gallamini A, Hutchings M, Rigacci L, Specht L, Merli F, Hansen M, 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(24):3746–52. - PubMed
    1. Kirby AM, Mikhaeel NG. The role of FDG PET in the management of lymphoma: what is the evidence base? Nucl Med Commun. 2007;28(5):335–54. - PubMed
    1. Hutchings M, Mikhaeel NG, Fields PA, Nunan T, Timothy AR. Prognostic value of interim FDG-PET after two or three cycles of chemotherapy in Hodgkin lymphoma. Ann Oncol. 2005;16(7):1160–8. - PubMed
    1. Hutchings M, Loft A, Hansen M, Pedersen LM, Buhl T, Jurlander J, et al. FDG-PET after two cycles of chemotherapy predicts treatment failure and progression-free survival in Hodgkin lymphoma. Blood. 2006;107(1):52–9. - PubMed
    1. Terasawa T, Lau J, Bardet S, Couturier O, Hotta T, Hutchings M, et al. Fluorine-18-fluorodeoxyglucose positron emission tomography for interim response assessment of advanced-stage Hodgkin’s lymphoma and diffuse large B-cell lymphoma: a systematic review. J Clin Oncol. 2009;27(11):1906–14. - PubMed

Substances