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European Journal of Nuclear Medicine and Molecular Imaging

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21.06.2017 | Original Article

Poor predictive value of positive interim FDG-PET/CT in primary mediastinal large B-cell lymphoma

verfasst von: Julien Lazarovici, Marie Terroir, Julia Arfi-Rouche, Jean-Marie Michot, Sacha Mussot, Valentina Florea, Maria-Rosa Ghigna, Peggy Dartigues, Cynthia Petrovanu, Alina Danu, Christophe Fermé, Vincent Ribrag, David Ghez

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 12/2017

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Abstract

Purpose

Though commonly used to assess response to therapy, the prognostic value of interim FDG-PET/CT in Primary Mediastinal Large B-cell Lymphoma (PMBCL) is unclear.

Methods

We conducted a retrospective study on 36 consecutive patients treated at our institution for a PMBCL between 2006 and 2014. All patients with a positive interim FDG-PET/CT had undergone histological restaging consisting either in a surgical debulking of the residual lesion (15 patients) or a CT-guided core needle biopsy (two patients). All FDG-PET/CT were secondarily reviewed according to the more recent Deauville criteria.

Results

Interim FDG-PET/CT was considered positive in 17/36 patients using visual evaluation. Among these patients, 14 had a Deauville score of 4. Histological restaging was negative in all but one case, showing inflammation and/or fibrosis. After a median follow-up of 48.5 months, a total of five patients have relapsed, two patients in the positive FDG-PET/CT group, and three patients in the negative FDG-PET/CT group, respectively.

Conclusions

These data indicate that a positive interim FDG-PET/CT does not reflect persistence of active disease in the vast majority of PMBCL cases. The relapse rate appears similar regardless of interim FDG-PET/CT results and interpretation criteria. This suggests that interim FDG-PET/CT has a poor positive predictive value, thus kt should be used with caution in PMBCL.

Martelli M, Di Rocco A, Russo E, Perrone S, Foa R. Primary mediastinal lymphoma: diagnosis and treatment options. Expert Rev Hematol. 2015;8(2):173–86.CrossRefPubMed

Aoki T, Izutsu K, Suzuki R, Nakaseko C, Arima H, Shimada K, et al. Prognostic significance of pleural or pericardial effusion and the implication of optimal treatment in primary mediastinal large B-cell lymphoma: a multicenter retrospective study in Japan. Haematologica. 2014;99(12):1817–25.CrossRefPubMedPubMedCentral

Kuruvilla J, Pintilie M, Tsang R, Nagy T, Keating A, Crump M. Salvage chemotherapy and autologous stem cell transplantation are inferior for relapsed or refractory primary mediastinal large B-cell lymphoma compared with diffuse large B-cell lymphoma. Leuk Lymphoma. 2008;49:1329–36.CrossRefPubMed

Barrington SF, Mikhaeel NG, Kostakoglu L, Meignan M, Hutchings M, Mueller SP, et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the international conference on malignant lymphomas imaging working group. J Clin Oncol. 2014;32(27):3048–58.CrossRefPubMedPubMedCentral

Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32(27):3059–68.CrossRefPubMedPubMedCentral

Adams HJ, Nievelstein RA, Kwee TC. Prognostic value of complete remission status at end-of-treatment FDG-PET in R-CHOP-treated diffuse large B-cell lymphoma: systematic review and meta-analysis. Br J Haematol. 2015;170(2):185–91.CrossRefPubMed

Adams HJ, Nievelstein RA, Kwee TC. Systematic review and meta-analysis on the prognostic value of complete remission status at FDG-PET in Hodgkin lymphoma after completion of first-line therapy. Ann Hematol. 2016;95(1):1–9.CrossRefPubMed

Juweid ME, Stroobants S, Hoekstra OS, Mottaghi FM, Dietlein M, Guermazi A, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the imaging Subcommittee of International Harmonization Project in lymphoma. J Clin Oncol. 2007;25(5):571–8.CrossRefPubMed

Cerci JJ, Pracchia LF, Linardi CC, Pitella FA, Delbeke D, Izaki M, et al. 18F-FDG PET after 2 cycles of ABVD predicts event-free survival in early and advanced Hodgkin lymphoma. J Nucl Med. 2010;51(9):1337–43.CrossRefPubMed

10.

Gallamini A, Rigacci L, Merli F, Nassi L, Bosi A, Capodanno I, et al. The predictive value of positron emission tomography scanning performed after two courses of standard therapy on treatment outcome in advanced stage Hodgkin’s disease. Haematologica. 2006;91(4):475–81.PubMed

11.

Hutchings M, Kostakoglu L, Zaucha JM, Malkowski B, Biggi A, Danielewicz I, et al. In vivo treatment sensitivity testing with positron emission tomography/computed tomography after one cycle of chemotherapy for Hodgkin lymphoma. J Clin Oncol. 2014;32(25):2705–11.CrossRefPubMed

12.

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.CrossRefPubMed

13.

Zinzani PL, Rigacci L, Stefoni V, Broccoli A, Puccini B, Castagnoli A, et al. Early interim 18F-FDG PET in Hodgkin’s lymphoma: evaluation on 304 patients. Eur J Nucl Med Mol Imaging. 2012;39(1):4–12.CrossRefPubMed

14.

Adams HJ, Kwee TC. Controversies on the prognostic value of interim FDG-PET in advanced-stage Hodgkin lymphoma. Eur J Haematol. 2016;97(6):491–8.CrossRefPubMed

15.

Gonzalez-Barca E, Canales M, Cortes M, Vidal MJ, Salar A, Oriol A, et al. Predictive value of interim 18F-FDG-PET/CT for event-free survival in patients with diffuse large B-cell lymphoma homogenously treated in a phase II trial with six cycles of R-CHOP-14 plus pegfilgrastim as first-line treatment. Nucl Med Commun. 2013;34(10):946–52.CrossRefPubMed

16.

Itti E, Meignan M, Berriolo-Riedinger A, Biggi A, Cashen AF, Vera P, et al. An international confirmatory study of the prognostic value of early PET/CT in diffuse large B-cell lymphoma: comparison between Deauville criteria and DeltaSUVmax. Eur J Nucl Med Mol Imaging. 2013;40(9):1312–20.CrossRefPubMed

17.

Mamot C, Klingbiel D, Hitz F, Renner C, Pabst T, Driessen C, et al. Final results of a prospective evaluation of the predictive value of interim positron emission tomography in patients with diffuse large B-cell lymphoma treated with R-CHOP-14 (SAKK 38/07). J Clin Oncol. 2015;33(23):2523–9.CrossRefPubMed

18.

Moskowitz CH, Schoder H, Teruya-Feldstein J, Sima C, Iasonos A, Portlock CS, et al. Risk-adapted dose-dense immunochemotherapy determined by interim FDG-PET in advanced-stage diffuse large B-cell lymphoma. J Clin Oncol. 2010;28(11):1896–903.CrossRefPubMedPubMedCentral

19.

Itti E, Lin C, Dupuis J, Paone G, Capacchione D, Rahmouni A, et al. Prognostic value of interim 18F-FDG PET in patients with diffuse large B-cell lymphoma: SUV-based assessment at 4 cycles of chemotherapy. J Nucl Med. 2009;50(4):527–33.CrossRefPubMed

20.

Cheah CY, Hofman MS, Seymour JF, Ritchie DS, Dickinson M, Wirth A, et al. The utility and limitations of 18F-fluorodeoxyglucose positron emission tomography with computed tomography in patients with primary mediastinal B-cell lymphoma: single institution experience and literature review. Leuk Lymphoma. 2015;56(1):49–56.CrossRefPubMed

21.

Filippi AR, Piva C, Giunta F, Bello M, Chiapella A, Caracciolo D, et al. Radiation therapy in primary mediastinal B-cell lymphoma with positron emission tomography positivity after rituximab chemotherapy. Int J Radiat Oncol Biol Phys. 2013;87(2):311–6.CrossRefPubMed

22.

Martelli M, Ceriani L, Zucca E, Zinzani PL, Ferreri AJ, Vitolo U, et al. [18F]fluorodeoxyglucose positron emission tomography predicts survival after chemoimmunotherapy for primary mediastinal large B-cell lymphoma: results of the international Extranodal lymphoma study group IELSG-26 study. J Clin Oncol. 2014;32(17):1769–75.CrossRefPubMed

23.

Vassilakopoulos TP, Pangalis GA, Chatziioannou S, Papageorgiou S, Angelopoulou MK, Galani Z, et al. PET/CT in primary mediastinal large B-cell lymphoma responding to rituximab-CHOP: an analysis of 106 patients regarding prognostic significance and implications for subsequent radiotherapy. Leukemia. 2016;30(1):238–42.CrossRefPubMed

24.

Meignan M, Gallamini A, Meignan M, Gallamini A, Haioun C. Report on the first international workshop on interim-PET-scan in lymphoma. Leuk Lymphoma. 2009;50(8):1257–60. doi:10.1080/10428190903040048.CrossRefPubMed

25.

Hamlin PA, Portlock CS, Straus DJ, Noy A, Singer A, Horwitz SM, et al. Primary mediastinal large B-cell lymphoma: optimal therapy and prognostic factor analysis in 141 consecutive patients treated at memorial Sloan Kettering from 1980 to 1999. Br J Haematol. 2005;130(5):691–9. doi:10.1111/j.1365-2141.2005.05661.x.CrossRefPubMed

26.

Savage KJ, Al-Rajhi N, Voss N, Paltiel C, Klasa R, Gascoyne RD, et al. Favorable outcome of primary mediastinal large B-cell lymphoma in a single institution: the British Columbia experience. Ann Oncol. 2006;17(1):123–30. doi:10.1093/annonc/mdj030.CrossRefPubMed

27.

Zinzani PL, Martelli M, Bertini M, Gianni AM, Devizzi L, Federico M, et al. Induction chemotherapy strategies for primary mediastinal large B-cell lymphoma with sclerosis: a retrospective multinational study on 426 previously untreated patients. Haematologica. 2002;87(12):1258–64.PubMed

28.

Massoud M, Koscielny S, Lapusan S, Bosq J, Ribrag V. Primary mediastinal large B-cell lymphomas treated with dose-intensified CHOP alone or CHOP combined with radiotherapy. Leuk Lymphoma. 2008;49(8):1510–5. doi:10.1080/10428190802203788.CrossRefPubMed

29.

Tilly H, Lepage E, Coiffier B, Blanc M, Herbrecht R, Bosly A, et al. Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma. Blood. 2003;102(13):4284–9. doi:10.1182/blood-2003-02-0542.CrossRefPubMed

30.

Adams HJ, Kwee TC. Prognostic value of interim FDG-PET in R-CHOP-treated diffuse large B-cell lymphoma: systematic review and meta-analysis. Crit Rev Oncol Hematol. 2016;106:55–63.CrossRefPubMed

31.

Giunta F, Zotta M, Menga M, Balma M, Bello M, Passera R, et al. Using PET-CT in the restaging of primitive mediastinal B-cell lymphoma (PMBCL) after chemotherapy: which criteria should we use? Q J Nucl Med Mol Imaging. 2015;59(2):214–9.PubMed

32.

Avigdor A, Sirotkin T, Kedmi M, Ribakovsy E, Berkowicz M, Davidovitz Y, et al. The impact of R-VACOP-B and interim FDG-PET/CT on outcome in primary mediastinal large B cell lymphoma. Ann Hematol. 2014;93(8):1297–304. doi:10.1007/s00277-014-2043-y.CrossRefPubMed

33.

Zinzani PL, Tani M, Trisolini R, Fanti S, Stefoni V, Alifano M, et al. Histological verification of positive positron emission tomography findings in the follow-up of patients with mediastinal lymphoma. Haematologica. 2007;92(6):771–7.CrossRefPubMed

34.

Adams HJ. Proportion of false-positive lesions at interim and end-of-treatment FDG-PET in lymphoma as determined by histology: systematic review and meta-analysis. Eur J Radiol. 2016;85(11):1963–70.CrossRefPubMed

Titel: Poor predictive value of positive interim FDG-PET/CT in primary mediastinal large B-cell lymphoma
verfasst von: Julien Lazarovici
Marie Terroir
Julia Arfi-Rouche
Jean-Marie Michot
Sacha Mussot
Valentina Florea
Maria-Rosa Ghigna
Peggy Dartigues
Cynthia Petrovanu
Alina Danu
Christophe Fermé
Vincent Ribrag
David Ghez
Publikationsdatum: 21.06.2017
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 12/2017
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-017-3758-5

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

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