WebA Biblioteca Virtual em Sade uma colecao de fontes de informacao cientfica e tcnica em sade organizada e armazenada em formato eletrnico nos pases da Regio Latino-Americana e do Caribe, acessveis de forma universal na Internet de modo compatvel com as bases internacionais. Imaging 30, 13231341. Hodgkin lymphoma is most commonly diagnosed at 20 to 34 years of age; however, the median age at death is 68 because of the higher survival rate among younger patients.2,4, Genetic, infectious, and inflammatory etiologies increase the risk of lymphoma. Leuk. 18F-Fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) is the standard diagnostic test for end-of-treatment assessment in Hodgkin lymphoma1, which accounts for 10% of all diagnosed lymphomas2. WebDeauville scores improve the clinical utility of end-of-chemotherapy PET, as evidenced by an increase in positive predictive value to 72.7% from 44.4% on the basis of report alone. Barrington, S.F. ; Bartelink, H.; van Leeuwen, F.E. The Lugano classification system further modified staging by incorporating positron emission tomography/computed tomography (PET-CT) results to determine the staging of the lymphoma, Patients should follow up with an oncologist every three to six months for the first two years. Visit our dedicated information section to learn more about MDPI. Before Sci. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Revelle, W. psych: Procedures for Psychological, Psychometric, and Personality Research. They identified kurtosis associated with shorter progression-free survival of lymphoma patients, with analysis limited to first-order features14. Meignan, M., Gallamini, A., Meignan, M., Gallamini, A. Google Scholar. B symptoms (fevers, night sweats, weight loss) occur in up to 30% of patients; more common in advanced disease. To address this issue, we used data from two scanners to test the generalizability of our results. proved a correlation between lymph node density in standard-dose CT and malignancy in lymph node metastases of a lung cancer rat model by extracting and scanning lymph nodes before the histopathologic examination41. Ng, A.K. 1, 2, 3, 4, 5, 6 However, individuals who survive are at a high risk of secondary cancers and cardiovascular disease after chemoradiotherapy. Prognostic value of pretransplant FDG-PET in refractory/relapsed Hodgkin lymphoma treated with autologous stem cell transplantation: systematic review and meta-analysis. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). An open lymph node biopsy is preferred for diagnosis. A score of 4 or 5 is an indicator to consider escalating therapy.25 Patients with Hodgkin lymphoma with a Deauville score of 1 or 2 have been shown to have similar progression and mortality outcomes between radiotherapy and no further treatment.32 Patients who receive a score of 3 or 4 should receive additional chemotherapy and/or radiotherapy, and a score of 5 indicates the need for a biopsy (excisional or core needle) in addition to chemotherapy and radiotherapy.25 A positive biopsy should be considered refractory disease.25, Relapse rates for non-Hodgkin lymphoma are variable and based on the specific subtype. In a multivariable analysis, we identified two independent factors predicting treatment failure: pretransplant DS combined with rMTV41% and disease status (primary refractory vs. relapsed). CT radiomics to predict Deauville score 4 positive and negative Hodgkin lymphoma manifestations, https://doi.org/10.1038/s41598-022-24227-0. Corresponding Deauville criteria score 5. Another limitation related to the former is the small NPV obtained for SUV. It would also have been desirable to obtain data from a more consistent patient population with a consistent therapy regimen and identical time points of PET/CT. Disclaimer/Publishers Note: The statements, opinions and data contained in all publications are solely Particularly, there was a significant difference in PFS between patients with interim score 12 and those with score 3. 2016 Apr;95(5):695-706. doi: 10.1007/s00277-016-2619-9. The primary end point was the positron emission tomography (PET) response rate after two cycles by expert independent review using the Deauville score. "Score 3 should be interpreted according to the clinical context but in many Hodgkin Lymphoma patients indicates a good prognosis with standard treatment." We decided to analyze NECTs obtained for the PET attenuation correction. PET scan followed after a median uptake time of 68min (IQR, 63.576.5min). 2017 Nov 16;130(20):2196-2203. doi: 10.1182/blood-2017-06-788877. See further details. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate. CAS 2013 Dec;14(13):1348-56. doi: 10.1016/S1470-2045(13)70501-1. PubMed https://qiicr.org/tool/PETIndiC/ (2018). An alternative diagnostic method is desirable in both cases, ideally having the same diagnostic performance. ; project administration, S.P. Isasi CR, Lu P, Blaufox MD. Bookshelf The site is secure. Imaging https://doi.org/10.1007/s00259-021-05233-2 (2021). However, contrary to other groups concentrating more on baseline datasets of lymphoma patients13,42,43, we also gained knowledge about radiomics from interim PET/CTs at different time points of disease. and transmitted securely. Korula A, Fouzia NA, Devasia A, Kulkarni U, Abraham A, Srivastava A. Bair SM, Svoboda J. Response-Adapted Treatment Strategies in Hodgkin Lymphoma Using PET Imaging. WebDeauville five-point score (DS) is recommended for response assessment in international guidelines. An official website of the United States government. Methods. J. Nucl. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Usually, the target lesion was the one with the visually highest DS. Almost 21,000 people are projected to die from lymphoma in 2019, representing 3.5% of all cancer deaths. Paediatric and adolescent Hodgkin lymphoma: Information derived from diffuse organ uptake of 18F-fluorodeoxyglucose pre-treatment and on interim PET/CT. It would further limit radiation dose and is accessible country-wide9. WebDeauville five-point score (DS) is recommended for response assessment in international guidelines. 18F-FDG-PET/CT is standard to assess response in Hodgkin lymphoma by quantifying metabolic activity with the Deauville score. Diagn. How to cite this article: John JR, Oommen R, ; Alpert, N.M. FDG-PET in oncology: Theres more to it than looking at pictures. Surti, S. et al. Med. Role of imaging in the staging and response assessment of lymphoma: Consensus of the International Conference on Malignant Lymphomas Imaging Working Group. The resulting areas under the curve (AUCs) were rated as follows: 0.700.80 acceptable, 0.800.90 excellent, 0.901.00 outstanding diagnostic performance30. Aims: We aimed to validate DS in Hodgkin's lymphoma (HL) by retrospectively assigning this score to F-18 FDG PET-computed tomography (CT) studies done before 2016 and analyzing its concordance with the line of management. Our purpose in conducting this study was to find a method that can assist clinicians in optimizing individual patient treatment by identifying early non-responders who could benefit from a more aggressive treatment, while early responders could be treated less aggressively and thus with potentially fewer treatment-related adverse events. positive feedback from the reviewers. Deauville score versus ratio Deauville score in the interpretation of interim 18F-FDG PET-CT and in prediction of outcome in children with FDG-avid extra-nodal lymphomas. A full list of features with an ICC below 0.8 is given in the supplementary Table S5. Webfor Pediatric Hodgkin Lymphoma? Phys. Isik, E.G. Purpose: J Clin Oncol. The sensitivity, specificity, PPV, NPV and accuracy of interim DS in predicting a therapy response at 24 months were 80.4%, 100.0%, 100.0%, 40.0% and 82.7%, respectively. Frood, R. et al. The results of the present study show that the first-order feature median has a high sensitivity for DS4+ manifestations on two different scanners (scanner A: 0.91, scanner B: 0.85). PET/CT, however, is time International validation study for interim PET in ABVD-treated, advanced-stage Hodgkin lymphoma: Interpretation criteria and concordance rate among reviewers. 2002;359(9323):2065-2071. The data can be made publicly available on reasonable request. Early and late therapy response assessment with [. Disclaimer. ; Erdrich, A.S.; Hundsdoerfer, P.; Ruf, J.; Henze, G.; Schnberger, S.; Amthauer, H.; Hautzel, H. Explorative analyses on the value of interim PET for prediction of response in pediatric and adolescent non-Hodgkin lymphoma patients. Results: For 202 patients treated with chemotherapy with or without radiation therapy, the 5-year FFP was 89% (95% confidence interval 85%-93%). 77, e104e107. PMC Repeatability and reproducibility study of radiomic features on a phantom and human cohort. PubMed Central Flechsig, P. et al. Berenguer, R. et al. suggested a link between the non-contrast-enhanced CT-derived texture parameter kurtosis and shorter progression-free survival of lymphoma patients in an 18F-FDG-PET/CT study, including patients with Hodgkin lymphoma and aggressive Non-Hodgkin lymphoma14. CT contrast media could also be avoided, which is beneficial for lymphoma patients, since they are at increased risk of chronic renal insufficiency36. Search dates: April 18, May 17, and May 31, 2018, and August 30, 2019. PET/CT scanning and reconstruction details are summarized in Table 3. Subsequent chemotherapy toxicities include neuropathy, cardiotoxicity, and secondary cancers such as lung and breast, and should be considered in the shared decision-making process to select a treatment regimen. PET data from scanner B were reconstructed iteratively with Bayesian penalized likelihood reconstruction (GE Q.Clear) with a penalization factor of 450, which included time of flight analysis and point spread function modeling21. Score 3 should be interpreted according to the clinical context but in many Hodgkins Lymphoma patients indicates a good prognosis with standard treatment. However, if the lesion was difficult to delineate on the NECT images, the lesion with the next lower or comparable DS was considered. https://www.mdpi.com/openaccess. Laura J. Jensen. pROC: An open-source package for R and S+ to analyze and compare ROC curves. PET/CT, however, is time-consuming, cost-extensive, linked to high radiation and has a low availability. Epub 2016 Mar 2. and B.H. They found that CT density correlated with 18F-FDG uptake, 68Ga-DOTATOC uptake, and 68Ga-PSMA uptake and suggested a Hounsfield scale to differentiate benign from malignant lymph nodes. The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Institutional Review Board (or Ethics Committee) of Charit Berlin (protocol code [EA1/104/19] and date of approval [5-14-2019]). Med. Children and adolescents with newly diagnosed stage IA, IB, and IIA classical Hodgkin lymphoma younger than 18 years of age were assigned to treatment group 1 to be treated with two future research directions and describes possible research applications. PubMed Careers. Magn. Barrington, S. F. et al. Patients should follow up with an oncologist every three to six months for the first two years, every six to 12 months until year 3, then annually thereafter. Swerdlow, A.J. 14, 749762. Please note that many of the page functionalities won't work as expected without javascript enabled. BV-AVD demonstrated an improvement in the PET-negative rate compared with ABVD after two cycles. Department of Radiology, Charit-Universittsmedizin Berlin, Corporate Member of Freie Universitt Berlin, Humboldt-Universitt zu Berlin, and Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany, Laura J. Jensen,Damon Kim,Juliana Rieelmann,Bernd Hamm,Ingo G. Steffen,Thomas Elgeti&Sebastian N. Nagel, Department of Nuclear Medicine, Charit-Universittsmedizin Berlin, Corporate Member of Freie Universitt Berlin, Humboldt-Universitt zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353, Berlin, Germany, Julian M. M. Rogasch,Christian Furth&Holger Amthauer, Berlin Institute of Health (BIH), Berlin, Germany, You can also search for this author in methods, instructions or products referred to in the content. Treatment of lymphoma consists of chemotherapy alone or in combination with radiotherapy.24 Radiotherapy alone is not recommended.25 Toxicity from radiotherapy can lead to serious long-term complications such as secondary cancers in the irradiated area, including breast or lung cancers.25 Additionally, patients receiving chemotherapy can subsequently develop breast or lung cancers, melanoma, or acute myeloid leukemia.26,27 Patients who are older than 60 years at diagnosis have worse outcomes, regardless of the staging. No special Features are extracted from a region of interest (ROI) by mathematical-statistical processing, resulting in many quantifiable features to characterize different image properties10. The number of patients is relatively limited regarding the large number of analyzed variables. The study was designed to test if the PET-negative rate after two cycles of BV-AVD was superior to 75%. Radiomic features were extracted using PyRadiomics (Version 3.0)25,26, following the instructions of the Image Biomarker Standardisation Initiative (IBSI)27. official website and that any information you provide is encrypted Ann Hematol. R package version 4.71. Our results should be verified in larger, more consistent patient populations examined on CT scanners from additional vendors to affirm median as a robust feature across scanners and should be validated externally according to Shahzadi44 supporting clinical applicability. WebINTRODUCTION. Hodgkin's lymphoma. WebPatients 18 years of age and older with Hodgkin Lymphoma who have received auto-HSCT in the previous 45-120 days. Med. Finally, rPET showed a sensitivity, specificity, PPV, NPV and accuracy in predicting a therapy response at 24 months of 76.1%, 100%, 100%, 35.3% and 78.8%, respectively, with a cut-off of 1.31 and an AUC of 0.913 (CI, Hodgkin lymphoma is the third-most-common childhood malignancy. https://doi.org/10.1007/s11307-022-01703-7 (2022). 1993;341(8852):1051-1054. Open Access funding enabled and organized by Projekt DEAL. ; Hussein, M.H. CAS Lymphoma typically presents as painless adenopathy, with systemic symptoms of fever, unexplained weight loss, and night sweats occurring in more advanced stages of the disease. Flechsig et al. Google Scholar. This cutoff is of the highest relevance7,8. All further statistical analyses were then performed scanner-wise: differences between DS4+ and DS4 manifestations were assessed with the MannWhitney-U-test and single feature performances with the ROC-analysis. National Library of Medicine However, a clear tendency towards one texture feature or feature class that distinctly correlates with increased FDG uptake has not emerged yet. Lambin, P. et al. Hodgkin lymphoma (HL) is one of the most common cancer types in young adults with the incidence peaking in people in their 20s. Sci. To test the reliability of each feature, different feature reduction methods were applied. PET-CT is used for fluorodeoxyglucose-avid lymphoma subtypes, with symptoms alone being used for staging the remaining subtypes. and T.E. Web- The Deauville score for interpreting FDG-PET in lymphoma - Lugano classification for staging of lymphomas - Unfavorable prognostic factors early HL - IPS Hodgkin lymphoma; Figures - Lymph node regions lymphoma; CALCULATORS. sharing sensitive information, make sure youre on a federal . is an academic researcher. Rev. A bone marrow biopsy is now recommended only for diffuse large B-cell lymphoma with a negative PET-CT result.19. Kaste, S.C.; Howard, S.C.; McCarville, E.B. WebInterim PET/CT scan was performed after 23 cycles of therapy, and the response was assessed using the Deauville 5-point scales (5-PS) and a semi-quantitative assessment using the SUVmax reduction rate (SUVmax). The new staging system incorporates two symptom-based classifications: A (absence of symptoms) and B (presence of fever, weight loss, and night sweats) for Hodgkin lymphoma. Current paradigm of response to therapy in Hodgkins lymphoma. The z-test was used to compare the diagnostic accuracy of rPET versus DS at the interim PET-CT. Of the 52 patients, 46 (88.5%) showed a complete therapy response at follow-up and were classified as responders, whereas the remaining patients had disease progression and/or recurrence. The statistical analysis involved several steps. Radiol. Rep. 9, 1322. https://doi.org/10.1038/s41598-018-37197-z (2019). It is traditionally classified broadly as non-Hodgkin or Hodgkin lymphoma. Interestingly, even in NECT images, the feature median that ultimately describes the density of a lymphoma manifestation differentiated between DS4-positive and DS4-negative lesions, thereby showing constantly higher values in DS4-positive manifestations (numerical results of the radiomics analysis are provided in the supplementary Table S3; S3a for scanner A and S3b for scanner B). Management of classical Hodgkin lymphoma: a look at up to date evidence and current treatment approaches. Aggressive conventional chemotherapy compared with high-dose chemotherapy with autologous haemopoietic stem-cell transplantation for relapsed chemosensitive Hodgkin's disease: a randomised trial. https://doi.org/10.3390/jpm13030445, Subscribe to receive issue release notifications and newsletters from MDPI journals, You can make submissions to other journals. Score 3: Uptake > mediastinum but liver. Non-Hodgkin lymphoma can originate anywhere in the body, with specific subtypes originating in the gastrointestinal tract, skin, or central nervous system. Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. https://doi.org/10.1148/radiol.2020191145 (2020). Open lymph node biopsy should be used to definitively diagnose lymphoma. The https:// ensures that you are connecting to the Fischman, A.J. Methods: Ger, R. B. et al. Blood 2008;111:504-16. https://CRAN.R-project.org/package=psych. During clinical follow-up, those patients who had a recurrence/disease progression after completion of therapy were considered non-responders, and the remaining were deemed responders. https://CRAN.R-project.org/package=caret (2022). The 1 year PFS was 93.3% and no patient had Considering the ROC analysis, 32 features from the dataset of scanner A and 19 from the dataset of scanner B showed an AUC of at least 0.7. Progression-free survival (PFS) was well stratified according to a visual assessment of interim PET/CT using 5-PS (p < 0.001). To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Overall, 26 initial and 49 interim examinations were included. ; Kamal, N.M.; Elbehedy, R.; Hassan, T.H. Outcome-based interpretation of early interim PET in advanced-stage Hodgkin lymphoma. Scientific Reports (Sci Rep) the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, Correspondence to https://doi.org/10.1037//0033-2909.86.2.420 (1979). Use the Previous and Next buttons to navigate the slides or the slide controller buttons at the end to navigate through each slide. A Cochrane review that examined seven trials consisting of more than 2,500 adult patients with early Hodgkin lymphoma concluded that the use of combined therapy could increase progression-free survival with little difference between the overall survival rates.32 Short-term complications from radiotherapy include nausea, vomiting, headaches, fatigue, and dermatitis. volume12, Articlenumber:20008 (2022) Gambhir, S.S. Molecular imaging of cancer with positron emission tomography. Radiomics is a modern approach that allows quantitative assessment of medical images beyond apparent morphologic features10. Analysis of MRI and CT-based radiomics features for personalized treatment in locally advanced rectal cancer and external validation of published radiomics models. https://doi.org/10.1007/s11307-017-1155-x (2018). WebPre-transplant Deauville score (DS) is an imaging biomarker used for risk stratification in relapsed/refractory classical Hodgkin lymphoma (cHL). Required fields are marked *. 2013;54(11):2531-2533. ; Birch, J.M. Haploidentical Transplants with Post-Transplant Cyclophosphamide for Relapsed or Refractory Hodgkin Lymphoma: The Role of Comorbidity Index and Pretransplant Positron Emission Tomography. Https: //doi.org/10.3390/jpm13030445, Subscribe to receive issue release notifications and newsletters from MDPI journals, you make... Lymph node biopsy is preferred for diagnosis Elbehedy, R. ; Hassan, T.H time-consuming, cost-extensive linked... Number of analyzed variables were included an imaging biomarker used for staging the remaining subtypes the reliability each! Issue of 2016, this journal uses article numbers instead of page numbers 75 % Articlenumber:20008 ( 2022 Gambhir... Made publicly available on reasonable request of bv-avd was superior to 75 % non-Hodgkin lymphoma can originate anywhere the... Of page numbers Bartelink, H. ; van Leeuwen, F.E, 1322. https: //doi.org/10.1038/s41598-022-24227-0 and interim., M., Gallamini, A. Google Scholar score 3 should be interpreted according to former. Below 0.8 is given in the PET-negative rate compared with ABVD after two cycles as follows 0.700.80... Initial and 49 interim examinations were included the slide controller buttons at the end to navigate through slide! The curve ( AUCs ) were rated as follows: 0.700.80 acceptable, 0.800.90 excellent, 0.901.00 outstanding diagnostic.! The data can be made publicly available on reasonable request in children with FDG-avid Lymphomas! In both cases, ideally having the same diagnostic performance to navigate through each slide highest DS, S.S. imaging! Of early interim PET in advanced-stage Hodgkin lymphoma ( cHL ) 18, May 17, and Personality.. With the Deauville score in the supplementary Table S5 the study was designed to test generalizability..., visit http: //creativecommons.org/licenses/by/4.0/ classified broadly as non-Hodgkin or Hodgkin lymphoma manifestations https. But in many Hodgkins lymphoma patients, with specific subtypes originating in the rate! Navigate the slides or the slide controller buttons at the end to navigate the slides or slide! Hodgkin 's disease: a randomised trial wordmark and PubMed logo are registered trademarks of the Conference! Chl ), May 17, and Personality Research information derived from diffuse organ uptake of 18F-fluorodeoxyglucose and. Scan followed after a median uptake time of 68min ( IQR, 63.576.5min ), ;. Analyzed variables score 4 positive and negative Hodgkin lymphoma interim examinations were included the end to navigate the or... Was the one with the Deauville score versus ratio Deauville score a assessment.:2531-2533. ; Birch, J.M 5 ):695-706. doi: 10.1182/blood-2017-06-788877 comply our... For staging the remaining subtypes an open-source package for R and S+ to analyze NECTs obtained for PET. Of Health and Human Services ( HHS ), this journal uses article numbers instead of page.. ):2531-2533. ; Birch, J.M ):1348-56. doi: 10.1007/s00277-016-2619-9 scanning and reconstruction details summarized... Revelle, W. psych: Procedures for Psychological, Psychometric, and Personality Research predict Deauville score models... From diffuse organ uptake deauville score hodgkin lymphoma 18F-fluorodeoxyglucose pre-treatment and on interim PET/CT using 5-PS (
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