TY - JOUR
T1 - Poor predictive value of positive interim FDG-PET/CT in primary mediastinal large B-cell lymphoma
AU - Lazarovici, Julien
AU - Terroir, Marie
AU - Arfi-Rouche, Julia
AU - Michot, Jean Marie
AU - Mussot, Sacha
AU - Florea, Valentina
AU - Ghigna, Maria Rosa
AU - Dartigues, Peggy
AU - Petrovanu, Cynthia
AU - Danu, Alina
AU - Fermé, Christophe
AU - Ribrag, Vincent
AU - Ghez, David
N1 - Publisher Copyright:
© 2017, Springer-Verlag GmbH Germany.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Purpose: Though commonly used to assess response to therapy, the prognostic value of interim FDG-PET/CT in Primary Mediastinal Large B-cell Lymphoma (PMBCL) is unclear. Methods: We conducted a retrospective study on 36 consecutive patients treated at our institution for a PMBCL between 2006 and 2014. All patients with a positive interim FDG-PET/CT had undergone histological restaging consisting either in a surgical debulking of the residual lesion (15 patients) or a CT-guided core needle biopsy (two patients). All FDG-PET/CT were secondarily reviewed according to the more recent Deauville criteria. Results: Interim FDG-PET/CT was considered positive in 17/36 patients using visual evaluation. Among these patients, 14 had a Deauville score of 4. Histological restaging was negative in all but one case, showing inflammation and/or fibrosis. After a median follow-up of 48.5 months, a total of five patients have relapsed, two patients in the positive FDG-PET/CT group, and three patients in the negative FDG-PET/CT group, respectively. Conclusions: These data indicate that a positive interim FDG-PET/CT does not reflect persistence of active disease in the vast majority of PMBCL cases. The relapse rate appears similar regardless of interim FDG-PET/CT results and interpretation criteria. This suggests that interim FDG-PET/CT has a poor positive predictive value, thus kt should be used with caution in PMBCL.
AB - Purpose: Though commonly used to assess response to therapy, the prognostic value of interim FDG-PET/CT in Primary Mediastinal Large B-cell Lymphoma (PMBCL) is unclear. Methods: We conducted a retrospective study on 36 consecutive patients treated at our institution for a PMBCL between 2006 and 2014. All patients with a positive interim FDG-PET/CT had undergone histological restaging consisting either in a surgical debulking of the residual lesion (15 patients) or a CT-guided core needle biopsy (two patients). All FDG-PET/CT were secondarily reviewed according to the more recent Deauville criteria. Results: Interim FDG-PET/CT was considered positive in 17/36 patients using visual evaluation. Among these patients, 14 had a Deauville score of 4. Histological restaging was negative in all but one case, showing inflammation and/or fibrosis. After a median follow-up of 48.5 months, a total of five patients have relapsed, two patients in the positive FDG-PET/CT group, and three patients in the negative FDG-PET/CT group, respectively. Conclusions: These data indicate that a positive interim FDG-PET/CT does not reflect persistence of active disease in the vast majority of PMBCL cases. The relapse rate appears similar regardless of interim FDG-PET/CT results and interpretation criteria. This suggests that interim FDG-PET/CT has a poor positive predictive value, thus kt should be used with caution in PMBCL.
KW - 18FDG pet/Ct
KW - Positive predictive value
KW - Primary mediastinal large B-cell lymphoma
UR - http://www.scopus.com/inward/record.url?scp=85021150989&partnerID=8YFLogxK
U2 - 10.1007/s00259-017-3758-5
DO - 10.1007/s00259-017-3758-5
M3 - Article
C2 - 28634685
AN - SCOPUS:85021150989
SN - 1619-7070
VL - 44
SP - 2018
EP - 2024
JO - European Journal of Nuclear Medicine and Molecular Imaging
JF - European Journal of Nuclear Medicine and Molecular Imaging
IS - 12
ER -