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PET-CT for staging ...
PET-CT for staging and early response : results from the Response-Adapted Therapy in Advanced Hodgkin Lymphoma study.
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- Barrington, Sally F (author)
- King's College London
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- Kirkwood, Amy A (author)
- University College London
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- Franceschetto, Antonella (author)
- University of Modena and Reggio Emilia
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- Fulham, Michael J (author)
- Royal Prince Alfred Hospital
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- Roberts, Thomas H (author)
- University College London
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- Almquist, Helén (author)
- Lund University,Lunds universitet,Klinisk fysiologi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Physiology (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Brun, Eva (author)
- Lund University,Lunds universitet,Tumörmikromiljö,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Tumor microenvironment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Hjorthaug, Karin (author)
- Aarhus University Hospital
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- Viney, Zaid N (author)
- Guy's and St Thomas' NHS Foundation Trust
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- Pike, Lucy C (author)
- King's College London
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- Federico, Massimo (author)
- University of Modena and Reggio Emilia
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- Luminari, Stefano (author)
- University of Modena and Reggio Emilia
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Radford, John (author)
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Trotman, Judith (author)
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Fosså, Alexander (author)
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Berkahn, Leanne (author)
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- Molin, Daniel (author)
- Uppsala universitet,Experimentell och klinisk onkologi
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D'Amore, Francesco (author)
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Sinclair, Donald A (author)
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Smith, Paul (author)
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O'Doherty, Michael J (author)
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Stevens, Lindsey (author)
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Johnson, Peter W (author)
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(creator_code:org_t)
- American Society of Hematology, 2016
- 2016
- English.
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In: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 127:12, s. 1531-1538
- Related links:
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https://kclpure.kcl....
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http://www.ncbi.nlm....
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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Abstract
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- International guidelines recommend that positron emission tomography-computed tomography (PET-CT) should replace CT in Hodgkin lymphoma (HL). The aims of this study were to compare PET-CT with CT for staging and measure agreement between expert and local readers, using a 5-point scale (Deauville criteria), to adapt treatment in a clinical trial: Response-Adapted Therapy in Advanced Hodgkin Lymphoma (RATHL). Patients were staged 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 laboratories. Local readers optionally scored PET2 scans. The RATHL and PET-CT stages were compared. Agreement among 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 characterization of lesions in the vast majority. Five patients were upstaged by marrow biopsy and 7 by contrast-enhanced CT in the bowel and/or liver or spleen. PET2 agreement among experts (140 scans) with a κ (95% confidence interval) 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.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
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- ref (subject category)
- art (subject category)
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Blood
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- By the author/editor
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Barrington, Sall ...
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Kirkwood, Amy A
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Franceschetto, A ...
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Fulham, Michael ...
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Roberts, Thomas ...
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Almquist, Helén
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show more...
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Brun, Eva
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Hjorthaug, Karin
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Viney, Zaid N
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Pike, Lucy C
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Federico, Massim ...
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Luminari, Stefan ...
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Radford, John
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Trotman, Judith
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Fosså, Alexander
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Berkahn, Leanne
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Molin, Daniel
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D'Amore, Frances ...
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Sinclair, Donald ...
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Smith, Paul
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O'Doherty, Micha ...
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Stevens, Lindsey
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Johnson, Peter W
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Radiology Nuclea ...
- Articles in the publication
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Blood
- By the university
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Uppsala University
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Lund University