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European Journal of Nuclear Medicine and Molecular Imaging

14.02.2024 | Original Article

Prognostic value of baseline and interim [¹⁸F]FDG PET metabolic parameters in pediatric Hodgkin’s lymphoma

verfasst von: Mikhail Ya. Yadgarov, M. M. Dunaykin, G. I. Shestopalov, C. Kailash, E. D. Kireeva, N. V. Myakova, Yu. N. Likar

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging

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Abstract

Background

Hodgkin lymphoma (HL) in pediatric populations has a high survival rate but poses risks for long-term morbidities. Although [¹⁸F]fluoro‑2‑deoxy‑2‑d‑glucose positron emission tomography ([¹⁸F]FDG PET) scans offer potential for improved risk stratification, the definitive prognostic value of quantitative [¹⁸F]FDG PET parameters remains unclear for pediatric HL.

Methods

A single-center, retrospective study included pediatric patients diagnosed with HL between 2016 and 2023 treated according to EuroNet-PHL-C1 and DAL/GPOH-HD protocols. Patients underwent baseline and interim PET/CT scans after two chemotherapy cycles. Event-free survival (EFS) was the primary endpoint, Deauville score was the secondary endpoint. Quantitative [¹⁸F]FDG PET parameters included SUVmax, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) that were evaluated using two segmentation methods (SUV 2.5, 41% SUVmax). Survival outcomes were assessed using Cox regression analysis.

Results

A total of 115 patients (50 males, median age 14.2 years) were studied, with a median follow-up period of 35 months. During this period, 16 cases (13.9%) of relapse or progression were noted. Baseline and interim MTV 2.5, MTV 41%, TLG 2.5, and TLG 41%, along with interim SUVmax, were significantly associated with worse EFS and correlated with post-treatment Deauville scores. In multivariable analysis, interim MTV 2.5 > 0 ml (adj. hazard ratio, HR: 3.89, p = 0.009) and interim TLG 41% ≥ 30 g (adj. HR: 7.98, p = 0.006) were independent risk factors for EFS.

Conclusion

Baseline and interim [¹⁸F]FDG PET parameters can serve as significant prognostic indicators for EFS and treatment response in pediatric HL. These quantitative measures could enhance individualized, risk-adapted treatment strategies for children and adolescents with HL.

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Titel: Prognostic value of baseline and interim [18F]FDG PET metabolic parameters in pediatric Hodgkin’s lymphoma
verfasst von: Mikhail Ya. Yadgarov
M. M. Dunaykin
G. I. Shestopalov
C. Kailash
E. D. Kireeva
N. V. Myakova
Yu. N. Likar
Publikationsdatum: 14.02.2024
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-024-06643-8