PET-CT for staging and early response: results from the Response-Adapted Therapy in Advanced Hodgkin Lymphoma study.

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PET-CT for staging and early response : results from the Response-Adapted Therapy in Advanced Hodgkin Lymphoma study.

Barrington, Sally F (author): King's College London

Kirkwood, Amy A (author): University College London

Franceschetto, Antonella (author): University of Modena and Reggio Emilia

Fulham, Michael J (author): Royal Prince Alfred Hospital

Roberts, Thomas H (author): University College London

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

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

Hjorthaug, Karin (author): Aarhus University Hospital

Viney, Zaid N (author): Guy's and St Thomas' NHS Foundation Trust

Pike, Lucy C (author): King's College London

Federico, Massimo (author): University of Modena and Reggio Emilia

Luminari, Stefano (author): University of Modena and Reggio Emilia

Radford, John (author)

Trotman, Judith (author)

Fosså, Alexander (author)

Berkahn, Leanne (author)

Molin, Daniel (author): Uppsala universitet,Experimentell och klinisk onkologi

D'Amore, Francesco (author)

Sinclair, Donald A (author)

Smith, Paul (author)

O'Doherty, Michael J (author)

Stevens, Lindsey (author)

Johnson, Peter W (author)

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(creator_code:org_t)

American Society of Hematology, 2016
2016
English.
In: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 127:12, s. 1531-1538

Related links:: https://kclpure.kcl....; show more...; http://www.ncbi.nlm....; http://dx.doi.org/10...; https://urn.kb.se/re...; https://doi.org/10.1...; https://lup.lub.lu.s...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

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.

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Radiology Nuclea ...

Articles in the publication: Blood

By the university: Uppsala University; Lund University

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PET-CT for staging and early response : results from the Response-Adapted Therapy in Advanced Hodgkin Lymphoma study.

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