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  • Barrington, Sally FKing's College London (author)

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

  • Article/chapterEnglish2016

Publisher, publication year, extent ...

  • American Society of Hematology,2016
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-282631
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-282631URI
  • https://doi.org/10.1182/blood-2015-11-679407DOI
  • https://lup.lub.lu.se/record/8592550URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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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Added entries (persons, corporate bodies, meetings, titles ...)

  • Kirkwood, Amy AUniversity College London (author)
  • Franceschetto, AntonellaUniversity of Modena and Reggio Emilia (author)
  • Fulham, Michael JRoyal Prince Alfred Hospital (author)
  • Roberts, Thomas HUniversity College London (author)
  • Almquist, HelénLund 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(Swepub:lu)extLU-691 (author)
  • Brun, EvaLund 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(Swepub:lu)onk-ebr (author)
  • Hjorthaug, KarinAarhus University Hospital (author)
  • Viney, Zaid NGuy's and St Thomas' NHS Foundation Trust (author)
  • Pike, Lucy CKing's College London (author)
  • Federico, MassimoUniversity of Modena and Reggio Emilia (author)
  • Luminari, StefanoUniversity of Modena and Reggio Emilia (author)
  • Radford, John (author)
  • Trotman, Judith (author)
  • Fosså, Alexander (author)
  • Berkahn, Leanne (author)
  • Molin, DanielUppsala universitet,Experimentell och klinisk onkologi(Swepub:uu)danimoli (author)
  • D'Amore, Francesco (author)
  • Sinclair, Donald A (author)
  • Smith, Paul (author)
  • O'Doherty, Michael J (author)
  • Stevens, Lindsey (author)
  • Johnson, Peter W (author)
  • King's College LondonUniversity College London (creator_code:org_t)

Related titles

  • In:Blood: American Society of Hematology127:12, s. 1531-15380006-49711528-0020

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