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Furth, Christian; Meseck, Robert M.; Steffen, Ingo G.; Schoenberger, Stefan; Denecke, Timm; Henze, Günter; Hautzel, Hubertus; Hofheinz, Frank; Großer, Oliver; Hundsdoerfer, Patrick; Amthauer, Holger; Ruf, Juri

SUV‐measurements and patient‐specific corrections in pediatric Hodgkin‐lymphoma: Is there a benefit for PPV in early response assessment by FDG‐PET?

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  • Media type: E-Article
  • Title: SUV‐measurements and patient‐specific corrections in pediatric Hodgkin‐lymphoma: Is there a benefit for PPV in early response assessment by FDG‐PET?
  • Contributor: Furth, Christian; Meseck, Robert M.; Steffen, Ingo G.; Schoenberger, Stefan; Denecke, Timm; Henze, Günter; Hautzel, Hubertus; Hofheinz, Frank; Großer, Oliver; Hundsdoerfer, Patrick; Amthauer, Holger; Ruf, Juri
  • Published: Wiley, 2012
  • Published in: Pediatric Blood & Cancer, 59 (2012) 3, Seite 475-480
  • Language: English
  • DOI: 10.1002/pbc.24047
  • ISSN: 1545-5009; 1545-5017
  • Origination:
  • Footnote:
  • Description: AbstractBackgroundTo evaluate the influence of different SUV‐measurements and patient‐specific corrections thereof on the positive predictive value (PPV) of FDG‐PET in pediatric Hodgkin lymphoma (pHL) using SUV‐based response assessment.MethodsPET‐datasets of 33 children [female, n = 13, male, n = 20; range of age, 8.0–17.8 (mean, 15.0) years; follow‐up, 44.5–83.3 (mean 63.0) months] with HL were analyzed retrospectively. PET‐scans were obtained baseline (PET1) and after two cycles of chemotherapy (PET2). Within the leading lesion maximal SUV (SUVmax) and mean SUVs were generated by using isocontur‐thresholds for different volumes of interest: Absolute, SUV2.5; relative to SUVmax, SUVmean40% to SUVmean70%. Generated SUVs were adjusted to body weight (SUV) and corrected for body surface area (SUV_BSA), patient's blood glucose and a combination thereof. The decrease in SUV or respective derivates thereof between PET1 and PET2 (ΔSUV) was assessed for response prediction using receiver operating characteristics (ROC)‐analysis.ResultsThree patients had recurrence of disease. ROC‐analysis showed the most accurate differentiation of responders and non‐responders for ΔSUVmax_BSA [AUC, 0.97; P = 0.0026; sensitivity, 100%; specificity, 93.3%; PPV, 60.0%; negative predictive value (NPV), 100%; accuracy, 93.3%]. However, comparable results were obtained for conventional ΔSUVmax‐determination (AUC, 0.96; P = 0.0112; sensitivity, 100%; specificity, 90.0%; PPV, 50.0%; NPV, 100%; accuracy, 90.9%). Threshold‐based approaches were less effective or technically not performable in all patients.ConclusionsAt early response assessment by FDG‐PET, patient‐specific correction of ΔSUVmax by BSA improves PPV without impairment of excellent NPV in pHL. However, it is not statistically superior to simple ΔSUVmax‐analyses. Larger cohorts are needed to investigate this observation. Pediatr Blood Cancer 2012;59:475–480. © 2011 Wiley Periodicals, Inc.