A comparative study of standardized quantitative and visual assessment for predicting tumor volume and outcome in newly diagnosed diffuse large B-cell lymphoma staged with 18F-FDG PET/CT
Autor: | Mikkel H. Vendelbo, Tarec Christoffer El-Galaly, Ate Haraldsen, Mette Abildgaard Pedersen, Trond Velde Bogsrud, Lars C. Gormsen, Karen Juul Jensen, Karin Hjorthaug, Lars Jelstrup Petersen, Rasmus Froberg Brøndum |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
lcsh:Medical physics. Medical radiology. Nuclear medicine
medicine.medical_specialty MTV Visual analogue scale IMPACT lcsh:R895-920 MULTICENTER Newly diagnosed REGIMENS CLASSIFICATION 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine TOMOGRAPHY Visual assessment Medicine Radiology Nuclear Medicine and imaging RITUXIMAB Cardiac imaging Original Research business.industry TRANSPLANTATION 18F-FDG PET/CT CHEMOTHERAPY medicine.disease Prognosis Lymphoma 030220 oncology & carcinogenesis DLBCL SURVIVAL Fdg pet ct TRIAL Radiology business Diffuse large B-cell lymphoma Kappa |
Zdroj: | Gormsen, L C, Vendelbo, M H, Pedersen, M A, Haraldsen, A, Hjorthaug, K, Bogsrud, T V, Petersen, L J, Jensen, K J, Brøndum, R & El-Galaly, T C 2019, ' A comparative study of standardized quantitative and visual assessment for predicting tumor volume and outcome in newly diagnosed diffuse large B-cell lymphoma staged with 18F-FDG PET/CT ' EJNMMI research, vol. 9, 36 . https://doi.org/10.1186/s13550-019-0503-z Gormsen, L C, Vendelbo, M H, Pedersen, M A, Haraldsen, A, Hjorthaug, K, Bogsrud, T V, Petersen, L J, Jensen, K J, Brøndum, R & El-Galaly, T C 2019, ' A comparative study of standardized quantitative and visual assessment for predicting tumor volume and outcome in newly diagnosed diffuse large B-cell lymphoma staged with 18F-FDG PET/CT ', EJNMMI Research, vol. 9, no. 1, 36, pp. 1-8 . https://doi.org/10.1186/s13550-019-0503-z EJNMMI Research Gormsen, L C, Vendelbo, M H, Pedersen, M A, Haraldsen, A, Hjorthaug, K, Bogsrud, T V, Petersen, L J, Jensen, K J, Brøndum, R & El-Galaly, T C 2019, ' A comparative study of standardized quantitative and visual assessment for predicting tumor volume and outcome in newly diagnosed diffuse large B-cell lymphoma staged with 18F-FDG PET/CT ', EJNMMI Research, vol. 9, 36 . https://doi.org/10.1186/s13550-019-0503-z Gormsen, L C, Vendelbo, M H, Pedersen, M A, Haraldsen, A, Hjorthaug, K, Bogsrud, T V, Petersen, L J, Jensen, K J, Brøndum, R & El-Galaly, T C 2019, ' A comparative study of standardized quantitative and visual assessment for predicting tumor volume and outcome in newly diagnosed diffuse large B-cell lymphoma staged with 18F-FDG PET/CT ', EJNMMI research, vol. 9, no. 1, 36 . https://doi.org/10.1186/s13550-019-0503-z EJNMMI Research, Vol 9, Iss 1, Pp 1-8 (2019) |
Popis: | Background: Semi-automated quantitative measurement of metabolic tumor volume (MTV) for prognosis in diffuse large B-Cell lymphoma (DLBCL) has gained considerable interest lately. However, simple tumor volume measures may be inadequate for assessment of prognosis in DLBCL as other characteristics such as growth pattern and metabolic heterogeneity may be just as important. In addition, MTV measurements require delineation of tumor lesions by semi-automated software, which can be time-consuming. We hypothesized that a simple visual assessment of tumor volume performs as well as standardized MTV measurements in DLBCL prognostication. Materials and methods: Quantitative and visual analyses of pre-therapy 18F-FDG PET/CT scans in 118 patients with newly diagnosed DLBCL were conducted. Quantitative analyses were performed using Hermes TumourFinder® to obtain MTV 2.5 (SUV 2.5 cut-off) and MTV 41 (41% SUVmax isocontour cut-off). Visual assessments included a binary prediction (good/poor prognosis) as well as tumor burden based on a visual analog scale (MTV VAS ) and an estimated volume (eMTV). Three experienced nuclear medicine physicians who were blinded to clinical outcome performed visual evaluations. Progression-free survival was evaluated by Kaplan-Meier curves and log-rank test. Inter-observer variability was evaluated by Fleiss’ kappa for multiple observers. Results: In the quantitative analysis, a ROC-determined MTV 2.5 cut-off (log-rank p = 0.11) seemed to outperform MTV 41 (log-rank p = 0.76) for PFS prediction. TLG2.5 (log-rank p = 0.14) and TLG41 (log-rank p = 0.34) were not associated with outcomes. By visual analysis, all three reviewers were able to stratify patients into good/poor prognosis (reviewer A log-rank p = 0.002, reviewer B log-rank p = 0.016, and reviewer C log-rank p = 0.012) with fair inter-observer agreement (Fleiss’ kappa 0.47). MTV VAS and eMTV were not consistently correlated with the outcome. Conclusion: Predictions of outcome after first-line treatment for DLBCL were surprisingly good when left to the unsupervised, subjective judgment of experienced readers of lymphoma 18F-FDG-PET/CT. The study highlights the importance of non-standardized clinical judgments and shows potential loss of valuable prognostic information when relying solely on semi-automated MTV measurements. |
Databáze: | OpenAIRE |
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