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Reed JD, Masenge A, Buchner A, Omar F, Reynders D, Vorster M, Van de Wiele C, Sathekge M. The Utility of Metabolic Parameters on Baseline F-18 FDG PET/CT in Predicting Treatment Response and Survival in Paediatric and Adolescent Hodgkin Lymphoma. J Clin Med 2021; 10:jcm10245979. [PMID: 34945274 PMCID: PMC8706037 DOI: 10.3390/jcm10245979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
Lymphoma is the third most common paediatric cancer. Early detection of high-risk patients is necessary to anticipate those who require intensive therapy and follow-up. Current literature shows that residual tumor avidity on PET (Positron Emission Tomography) following chemotherapy corresponds with decreased survival. However, the value of metabolic parameters has not been adequately investigated. In this retrospective study, we aimed to evaluate the prognostic value of metabolic and other parameters in paediatric and adolescent Hodgkin lymphoma. We recorded tMTV (total Metabolic Tumor Volume), TLG (Total Lesion Glycolysis), and SUVmax (maximum Standard Uptake Value) on baseline PET, as well the presence of bone marrow or visceral involvement. HIV (human immunodeficiency virus) status and baseline biochemistry from clinical records were noted. All patients received stage-specific standard of care therapy. Response assessment on end-of-treatment PET was evaluated according to the Deauville criteria. We found that bone marrow involvement (p = 0.028), effusion (p < 0.001), and treatment response (p < 0.001) on baseline PET, as well as HIV status (p = 0.036) and baseline haemoglobin (p = 0.039), were significantly related to progression-free survival (PFS), whereas only effusion (p = 0.017) and treatment response (p = 0.050) were predictive of overall survival (OS). Only baseline tMTV predicted treatment response (p = 0.017). This confirms the value of F-18 FDG PET/CT (Fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography) in prognostication in paediatric and adolescent Hodgkin lymphoma; however, further studies are required to define the significance of metabolic parameters.
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Affiliation(s)
- Janet Denise Reed
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0002, South Africa;
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Correspondence: (J.D.R.); (C.V.d.W.); (M.S.); Tel.: +012-354-2273 & +012-354-1794 (M.S.)
| | - Andries Masenge
- Department of Statistics, University of Pretoria, Pretoria 0002, South Africa;
| | - Ane Buchner
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Department of Paediatric Oncology, University of Pretoria, Pretoria 0002, South Africa
| | - Fareed Omar
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Department of Paediatric Oncology, University of Pretoria, Pretoria 0002, South Africa
| | - David Reynders
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Department of Paediatric Oncology, University of Pretoria, Pretoria 0002, South Africa
| | - Mariza Vorster
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0002, South Africa;
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
| | - Christophe Van de Wiele
- Department of Radiology and Nuclear Medicine, University of Ghent, 9000 Ghent, Belgium
- Correspondence: (J.D.R.); (C.V.d.W.); (M.S.); Tel.: +012-354-2273 & +012-354-1794 (M.S.)
| | - Mike Sathekge
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0002, South Africa;
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Correspondence: (J.D.R.); (C.V.d.W.); (M.S.); Tel.: +012-354-2273 & +012-354-1794 (M.S.)
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Kluge R, Kurch L, Georgi T, Metzger M. Current Role of FDG-PET in Pediatric Hodgkin's Lymphoma. Semin Nucl Med 2017; 47:242-257. [PMID: 28417854 DOI: 10.1053/j.semnuclmed.2017.01.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hodgkin's lymphoma is one of the most curable pediatric cancers with long-term survival rates exceeding 90% following intensive treatment. Collaborative group studies worldwide aim on reduction or elimination of radiotherapy to avoid potentially life-limiting late effects especially second cancers and cardiovascular diseases. Large prospective trials have integrated early response FDG-PET scans to identify adequate responders to chemotherapy in whom radiotherapy may safely be omitted. The criteria for interpretation of early response PET have changed during the past years and will be further refined based on trial results. FDG-PET is also systematically used to assess initial disease involvement of pediatric Hodgkin's lymphoma and could replace bone marrow biopsy. This article summarizes the role of FDG-PET in staging and response assessment focusing on large pediatric trials, the criteria for PET interpretation and pitfalls.
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Affiliation(s)
- Regine Kluge
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany.
| | - L Kurch
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Thomas Georgi
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Monika Metzger
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN
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