Poor predictive value of positive interim FDG-PET/CT in primary mediastinal large B-cell lymphoma

Julien Lazarovici, Marie Terroir, Julia Arfi-Rouche, Jean Marie Michot, Sacha Mussot, Valentina Florea, Maria Rosa Ghigna, Peggy Dartigues, Cynthia Petrovanu, Alina Danu, Christophe Fermé, Vincent Ribrag, David Ghez

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Résumé

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.

langue originaleAnglais
Pages (de - à)2018-2024
Nombre de pages7
journalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume44
Numéro de publication12
Les DOIs
étatPublié - 1 nov. 2017
Modification externeOui

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