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- Title
qPET - a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma.
- Authors
Hasenclever, Dirk; Kurch, Lars; Mauz-Körholz, Christine; Elsner, Andreas; Georgi, Thomas; Wallace, Hamish; Landman-Parker, Judith; Moryl-Bujakowska, Angelina; Cepelová, Michaela; Karlén, Jonas; Álvarez Fernández-Teijeiro, Ana; Attarbaschi, Andishe; Fosså, Alexander; Pears, Jane; Hraskova, Andrea; Bergsträsser, Eva; Beishuizen, Auke; Uyttebroeck, Anne; Schomerus, Eckhard; Sabri, Osama
- Abstract
Background: Interim FDG-PET is used for treatment tailoring in lymphoma. Deauville response criteria consist of five ordinal categories based on visual comparison of residual tumor uptake to physiological reference uptakes. However, PET-response is a continuum and visual assessments can be distorted by optical illusions. Objectives: With a novel semi-automatic quantification tool we eliminate optical illusions and extend the Deauville score to a continuous scale. Patients and methods: SUV of residual tumors and average uptake of the liver is measured with standardized volumes of interest. The qPET value is the quotient of these measurements. Deauville scores and qPET-values were determined in 898 pediatric Hodgkin's lymphoma patients after two OEPA chemotherapy cycles. Results: Deauville categories translate to thresholds on the qPET scale: Categories 3, 4, 5 correspond to qPET values of 0.95, 1.3 and 2.0, respectively. The distribution of qPET values is unimodal with a peak representing metabolically normal responses and a tail of clearly abnormal outliers. In our patients, the peak is at qPET = 0.95 coinciding with the border between Deauville 2 and 3. qPET cut values of 1.3 or 2 (determined by fitting mixture models) select abnormal metabolic responses with high sensitivity, respectively, specificity. Conclusions: qPET methodology provides semi-automatic quantification for interim FDG-PET response in lymphoma extending ordinal Deauville scoring to a continuous scale. Deauville categories correspond to certain qPET cut values. Thresholds between normal and abnormal response can be derived from the qPET-distribution without need for follow-up data. In our patients, qPET < 1.3 excludes abnormal response with high sensitivity.
- Subjects
IMAGING systems; VISUAL evoked response; OPTICAL illusions; LYMPHOMA treatment; TUMORS; HODGKIN'S disease
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2014, Vol 41, Issue 7, p1301
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-014-2715-9