Incidence of post-treatment PET-positivity and relapse in Hodgkin lymphoma patients with a negative interim FDG-PET

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorZANONI, L.
dc.contributor.authorCERCI, J.
dc.contributor.authorLOPCI, E.
dc.contributor.authorBIANCHI, A.
dc.contributor.authorHUTCHINGS, M.
dc.contributor.authorLEE, S. Ting
dc.contributor.authorDELBEKE, D.
dc.contributor.authorCELLI, M.
dc.contributor.authorCHITI, A.
dc.contributor.authorFANTI, S.
dc.date.accessioned2013-10-11T21:26:15Z
dc.date.available2013-10-11T21:26:15Z
dc.date.issued2012
dc.description.abstractBackground: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), used for assessment of early response in Hodgkin’s lymphoma (HL) patients, is an accurate predictor of progression-free survival. Is has been suggested that end-treatment PET (PETe) is unnecessary if interim PET (PETi) results are negative. The purpose of this study was to evaluate the incidence and clinical characteristics of HL patients with PETi-negative and PETe-positive scans. Material and Methods: For this purpose we retrospectively analyzed data from HL patients enrolled in seven different nuclear medicine centers worldwide. Scans were read by at least one board certified nuclear physician. PETi-negative was defined as no pathologic FDG uptake at any site, including all sites of previously increased pathologic uptake. PETi minimal residual uptake (MRU) was defined as low-grade FDG uptake, although PETi-MRU scans were considered as PETi-negative scan for the purpose of the analysis. A study was considered PETi-positive in case of focal FDG uptake that could not be attributed to physiological distribution. There was no modification in treatment based on PETi results. The incidence of a PETi-negative scan in combination with a PETe-positive scan was calculated. Results: A total of 868 patients were analysed and after two or three cycles of chemotherapy, 643/868 (74.1%) patients were PETi-negative, and 225/868 (25.9%) were PETi-positive. Of the 643 PETi-negative patients, 7.2% (46/643) showed PETe-positive scans. HL was confirmed in 5.1% (33/643) patients, while 2.2% (14/643) were false positive results. Four of those patients died during follow-up, due to HL complications, with a median follow up of 47 (±24.1) months. Clinical characteristics of the 33 early relapsed patients were investigated (sex; age; pathological subtype; B symptoms; Bulky diseae; Clinical stage; International Prognostic Score). Of those patients, 81.8% (27/33) were treated with ABVD. Radiotherapy was administrated in 12 (33.6%) patients. Of the 13 patients with early stage disease, six (46.1%) were submitted to combined therapy. Of the 14 patients with advanced disease, six (42.8%) were submitted to combined therapy. Conclusion: We conclude that, although a rare occurrence, a small number of HL patients will show recurrent signs of disease at the end of treatment, despite a negative PETi. Thus, there is at present not evidence for the omission of PETe. PETe should still be performed as part of the patient's management plan , in order to identify these patients who need additional therapy.
dc.description.conferencedateOCT 27-31, 2012
dc.description.conferencelocalMilan, ITALY
dc.description.conferencename25th Annual Congress of the European-Association-of-Nuclear-Medicine (EANM)
dc.description.indexMEDLINE
dc.identifier.citationEUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, v.39, suppl.2, p.S374-S374, 2012
dc.identifier.issn1619-7070
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/3041
dc.language.isoeng
dc.publisherSPRINGER
dc.relation.ispartofEuropean Journal of Nuclear Medicine and Molecular Imaging
dc.rightsrestrictedAccess
dc.rights.holderCopyright SPRINGER
dc.subject.wosRadiology, Nuclear Medicine & Medical Imaging
dc.titleIncidence of post-treatment PET-positivity and relapse in Hodgkin lymphoma patients with a negative interim FDG-PET
dc.typeconferenceObject
dc.type.categorymeeting abstract
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryEstados Unidos
hcfmusp.affiliation.countryAustrália
hcfmusp.affiliation.countryDinamarca
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryisoit
hcfmusp.affiliation.countryisodk
hcfmusp.affiliation.countryisoau
hcfmusp.affiliation.countryisous
hcfmusp.author.externalZANONI, L.:St Orsola Malpighi, Bologna, Italy
hcfmusp.author.externalLOPCI, E.:IRCCS Humanitas, Milan, Italy
hcfmusp.author.externalBIANCHI, A.:S Croce Hosp, Cuneo, Italy
hcfmusp.author.externalHUTCHINGS, M.:Copenhagen Univ Hosp, Copenhagen, Denmark
hcfmusp.author.externalLEE, S. Ting:Austin Hlth, Ctr PET, Melbourne, Vic, Australia
hcfmusp.author.externalDELBEKE, D.:Vanderbilt Univ, Med Ctr, Nashville, TN USA
hcfmusp.author.externalCELLI, M.:St Orsola Malpighi, Bologna, Italy
hcfmusp.author.externalCHITI, A.:IRCCS Humanitas, Milan, Italy
hcfmusp.author.externalFANTI, S.:St Orsola Malpighi, Bologna, Italy
hcfmusp.contributor.author-fmusphcJULIANO JULIO CERCI
hcfmusp.description.beginpageS374
hcfmusp.description.endpageS374
hcfmusp.description.issuesuppl 2
hcfmusp.description.volume39
hcfmusp.origemWOS
hcfmusp.origem.wosWOS:000309726601278
hcfmusp.publisher.cityNEW YORK
hcfmusp.publisher.countryUSA
relation.isAuthorOfPublication7445ec8e-f402-4668-a9fc-73f9acea0735
relation.isAuthorOfPublication.latestForDiscovery7445ec8e-f402-4668-a9fc-73f9acea0735
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