PET-CT for staging & early response: results from 'Response Adapted Therapy in Advanced Hodgkin Lymphoma' (RATHL) (CRUK/07/033).
Authors
Barrington, SKirkwood, A
Franceschetto, A
Fulham, M
Roberts, T
Almquist, H
Brun, E
Hjorthaug, K
Viney, Z
Pike, L
Federico, M
Luminari, S
Radford, John A
Trotman, J
Fosså, A
Berkahn, L
Molin, D
D'Amore, F
Sinclair, D
Smith, P
O'Doherty, M
Stevens, L
Johnson, P
Affiliation
PET Imaging Centre, Division of Imaging Sciences and Biomedical Engineering, King's College LondonIssue Date
2016-01-08
Metadata
Show full item recordAbstract
International guidelines recommend PET-CT should replace CT in Hodgkin Lymphoma (HL). The aims of this study were to i) compare PET-CT with CT for staging and ii) measure agreement between expert and local readers, using a five-point scale (Deauville criteria), to adapt treatment in a clinical trial 'Response Adapted Therapy in Advanced Hodgkin Lymphoma' (RATHL) www.cancer.gov/clinicaltrials, reference NCT00678327. Patients were staged for the trial using clinical assessment, CT and bone marrow biopsy (RATHL stage). PET-CT was performed at baseline (PET0) and after 2 chemotherapy cycles (PET2) in a response-adapted design. PET-CT was reported centrally by experts at 5 national core labs. Local readers optionally scored PET2 scans. The RATHL and PET-CT stages were compared. Agreement amongst experts and between expert and local readers was measured. RATHL and PET0 stage were concordant in 938 (80%) patients. PET-CT upstaged 159 (14%) and downstaged 74 (6%) patients. Upstaging by extranodal disease in bone marrow (92), lung (11) or multiple sites (12) on PET-CT accounted for most discrepancies. Follow-up of discrepant findings confirmed the PET characterisation of lesions in the vast majority. Five patients were upstaged by marrow biopsy; 7 by contrast-enhanced CT in bowel and/or liver or spleen. PET2 agreement amongst experts (140 scans) with kappa (95% CI) of 0.84 (0.76 - 0.91) was very good and between experts and local readers (300 scans) at 0.77 (0.68-0.86) was good. These results confirm PET-CT as the modern standard for staging HL and that response assessment using Deauville criteria is robust enabling translation of RATHL results into clinical practice.Citation
PET-CT for staging & early response: results from 'Response Adapted Therapy in Advanced Hodgkin Lymphoma' (RATHL) (CRUK/07/033). 2016: BloodJournal
BloodDOI
10.1182/blood-2015-11-679407PubMed ID
26747247Type
ArticleLanguage
enISSN
1528-0020ae974a485f413a2113503eed53cd6c53
10.1182/blood-2015-11-679407
Scopus Count
Collections
Related articles
- US Intergroup Trial of Response-Adapted Therapy for Stage III to IV Hodgkin Lymphoma Using Early Interim Fluorodeoxyglucose-Positron Emission Tomography Imaging: Southwest Oncology Group S0816.
- Authors: Press OW, Li H, Schöder H, Straus DJ, Moskowitz CH, LeBlanc M, Rimsza LM, Bartlett NL, Evens AM, Mittra ES, LaCasce AS, Sweetenham JW, Barr PM, Fanale MA, Knopp MV, Noy A, Hsi ED, Cook JR, Lechowicz MJ, Gascoyne RD, Leonard JP, Kahl BS, Cheson BD, Fisher RI, Friedberg JW
- Issue date: 2016 Jun 10
- Factors affecting intrapatient liver and mediastinal blood pool ¹⁸F-FDG standardized uptake value changes during ABVD chemotherapy in Hodgkin's lymphoma.
- Authors: Chiaravalloti A, Danieli R, Abbatiello P, Di Pietro B, Travascio L, Cantonetti M, Guazzaroni M, Orlacchio A, Simonetti G, Schillaci O
- Issue date: 2014 Jun
- Five-year follow-up of SWOG S0816: limitations and values of a PET-adapted approach with stage III/IV Hodgkin lymphoma.
- Authors: Stephens DM, Li H, Schöder H, Straus DJ, Moskowitz CH, LeBlanc M, Rimsza LM, Bartlett NL, Evens AM, LaCasce AS, Barr PM, Knopp MV, Hsi ED, Leonard JP, Kahl BS, Smith SM, Friedberg JW
- Issue date: 2019 Oct 10
- PET-CT: reliable cornerstone for Hodgkin lymphoma treatment?
- Authors: Zijlstra JM
- Issue date: 2016 Mar 24
- 2-deoxy-2[F-18] fluoro-D-glucose positron emission tomography Deauville scale and core-needle biopsy to determine successful management after six doxorubicin, bleomycin, vinblastine and dacarbazine cycles in advanced-stage Hodgkin lymphoma.
- Authors: Picardi M, Fonti R, Della Pepa R, Giordano C, Pugliese N, Nicolai E, Salvatore M, Mainolfi C, Venetucci P, Rascato MG, Cappuccio I, Mascolo M, Vigliar E, Troncone G, Del Vecchio S, Pane F
- Issue date: 2020 Jun