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The prognostic value of 18F-FDG PET-CT in the management of Hodgkin’s lymphoma: preliminary results of a prospective study
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Abstract
MATERIAL AND METHODS: We evaluated 21 consecutive patients affected by (HL) and presenting for assessment over a period of three years. All patients underwent initial staging with 18F-FDG-PET/CT along with standard staging procedures. We tailored an individual treatment plan dependent on pre-treatment risk factors and initial 18F-FDG-PET/CT. With the aim of the best definition of response to treatment, we repeated 18F-FDG-PET/CT after two (FDG-PET 2), four (FDG-PET 4) and six (FDG-PET 6) chemotherapy cycles. Chemotherapy was typically given for four cycles in early disease stages and was prolonged to six to eight cycles in advanced disease stages, depending on PET findings.
RESULTS: Our results showed a strong negative predictive value in detecting responders in early stage HL and a positive predictive value in advanced-stage patients. Clinical stage, extra-nodal sites and the positivity of the 18F-FDG-PET/CT performed during chemotherapy were also noted as strong determinants of response to treatment. Moreover, in our series the 18F-FDG-PET/CT data obtained after only two chemotherapy cycles (FDG-PET 2) were the same of those obtained after FDGPET 4 and FDG-PET 6 controls.
CONCLUSION: The preliminary data of the present study confirm those of previous published studies about the negative predictive value of 18F-FDG-PET/CT performed after four and six chemotherapy cycles, which contributed to the decision to stop treatment and to avoid radiotherapy in HL patients. Nonetheless, our preliminary data seems to suggest that only the 18F-FDG-PET/CT performed after two cycles of chemotherapy (FDG-PET 2) is able to provide the same prognostic information of the FDG-PET 4 and FDG-PET 6 earlier.
Abstract
MATERIAL AND METHODS: We evaluated 21 consecutive patients affected by (HL) and presenting for assessment over a period of three years. All patients underwent initial staging with 18F-FDG-PET/CT along with standard staging procedures. We tailored an individual treatment plan dependent on pre-treatment risk factors and initial 18F-FDG-PET/CT. With the aim of the best definition of response to treatment, we repeated 18F-FDG-PET/CT after two (FDG-PET 2), four (FDG-PET 4) and six (FDG-PET 6) chemotherapy cycles. Chemotherapy was typically given for four cycles in early disease stages and was prolonged to six to eight cycles in advanced disease stages, depending on PET findings.
RESULTS: Our results showed a strong negative predictive value in detecting responders in early stage HL and a positive predictive value in advanced-stage patients. Clinical stage, extra-nodal sites and the positivity of the 18F-FDG-PET/CT performed during chemotherapy were also noted as strong determinants of response to treatment. Moreover, in our series the 18F-FDG-PET/CT data obtained after only two chemotherapy cycles (FDG-PET 2) were the same of those obtained after FDGPET 4 and FDG-PET 6 controls.
CONCLUSION: The preliminary data of the present study confirm those of previous published studies about the negative predictive value of 18F-FDG-PET/CT performed after four and six chemotherapy cycles, which contributed to the decision to stop treatment and to avoid radiotherapy in HL patients. Nonetheless, our preliminary data seems to suggest that only the 18F-FDG-PET/CT performed after two cycles of chemotherapy (FDG-PET 2) is able to provide the same prognostic information of the FDG-PET 4 and FDG-PET 6 earlier.
Keywords
Hodgkin’s lymphoma; 18F-FDG-PET/CT; prognostic value
Title
The prognostic value of 18F-FDG PET-CT in the management of Hodgkin’s lymphoma: preliminary results of a prospective study
Journal
Issue
Pages
87-90
Published online
2007-05-23
Page views
484
Article views/downloads
1060
Bibliographic record
Nucl. Med. Rev 2007;10(2):87-90.
Keywords
Hodgkin’s lymphoma
18F-FDG-PET/CT
prognostic value
Authors
Rossella Paolini
Lucia Rampin
Elisabetta Rodella
Emilio Ramazzina
Elena Banti
Adil Al-Nahhas
Domenico Rubello