The Significance of PET/CT in the Initial Staging of Hodgkin Lymphoma: Experience Outside Clinical Trials

Anticancer Res. 2017 Oct;37(10):5727-5736. doi: 10.21873/anticanres.12011.

Abstract

Aim: To examine the real-life impact of baseline positron-emission tomography/computed tomography (PET/CT) in Hodgkin lymphoma (HL).

Patients and methods: A total of 162 consecutive patients with HL were retrospectively studied.

Results: Disease was up-staged in 26 patients (16%) and down-staged in 9 (6%). However, treatment strategy was modified in only 10 patients (6% of total). Involved field radiotherapy was delineated according to PET/CT in 36/66 patients (59%). These treatment modifications did not significantly affect outcome. Moreover, three potent prognostic parameters were identified: the number of involved sites, maximum standardized uptake value (SUVmax), and the product of SUVmax and maximal largest lesion diameter, as a surrogate of total lesion glycolysis. All three significantly correlated with 5-year freedom from disease progression p=0.004, p=0.009 and p=0.04, respectively).

Conclusion: Baseline PET/CT findings may lead to treatment modification in <15% of patients with HL without a significant impact on outcome. Certain PET/CT parameters have potent prognostic significance.

Keywords: 18FDG-PET/CT; Hodgkin lymphoma; involved field radiotherapy; prognostic factors; staging.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Female
  • Hodgkin Disease / diagnostic imaging*
  • Hodgkin Disease / mortality
  • Hodgkin Disease / therapy
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Staging / methods*
  • Positron Emission Tomography Computed Tomography*
  • Predictive Value of Tests
  • Reproducibility of Results
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome
  • Young Adult