; Hudson, M.M. Subsequent chemotherapy toxicities include neuropathy, cardiotoxicity, and secondary cancers such as lung and breast, and should be considered in the shared decision-making process to select a treatment regimen. Considering the results of the MWU test, 41 features from the dataset of scanner A and eight from the dataset of scanner B showed a significant difference between DS4-positive and DS4-negative lesions. The median age of patients at diagnosis of non-Hodgkin lymphoma is 67 years, and the median age at death is 76. Compared to the past, survivors have a longer post-exposure life expectancy, but can experience long-term and latent side effects of cancer treatment in a non-negligible proportion of cases, especially in a post-radiotherapy setting, with the added risk of new malignancies in the long run [, Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (, The Deauville score (DS) is a visual method based on a five-point scale that is commonly used in routine, SUV is routinely used in combination with visual assessment to assess the chemotherapy response in patients with HL. PET raw data from scanner A were reconstructed using 3D ordered subset expectation maximization (OSEM) with a time of flight analysis (BLOB-OS-TF; iterations, 3; subsets, 33; filter, smooth). Author to whom correspondence should be addressed. https://doi.org/10.1053/j.semnuclmed.2017.09.007 (2018). As an alternative, we investigated radiomics from non-contrast-enhanced computed tomography (NECT) scans. 20, 641649. Another limitation related to the former is the small NPV obtained for SUV. Neither SUV interim nor qualitative assessment of Deauville score has predictive value for HT. The first-order texture feature median describing lesion density derived from NECT concordantly has a high sensitivity for DS4+ Hodgkin manifestations on two different scanners. ; Contact Us Have a question, idea, or some feedback? Prognostic significance of interim PET/CT response for the treatment of advanced-stage marginal zone lymphoma in the post-rituximab era. "Are Semiquantitative Methods Superior to Deauville Scoring in the Monitoring Therapy Response for Pediatric Hodgkin Lymphoma?" The physician should focus on shared decision-making when discussing treatment options with all patients, but particularly for those older than 60 years, including whether the patient should pursue treatment.25, The standard treatment for Hodgkin lymphoma is ABVD (doxorubicin [Adriamycin], bleomycin, vinblastine [Velban], and dacarbazine), but other regimens such as the Stanford V (doxorubicin, vinblastine, mechlorethamine, etoposide [Toposar], vincristine, bleomycin, and prednisone) and escalated-BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine [Matulane], and prednisone) can be used.2428 Treatment for non-Hodgkin lymphoma varies depending on the histology, but often uses treatments such as CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) with or without rituximab (Rituxan; R-CHOP), a monoclonal antibody specific for CD20-positive B lymphocytes.29 Other medications such as bendamustine (Bendeka), an alkylating agent, and lenalidomide (Revlimid) are also used in many non-Hodgkin lymphoma treatments.30,31 Common complications of these therapies are listed in Table 5.2527,2936. Avigdor A, Bulvik S, Levi I, Dann EJ, Shemtov N, Perez-Avraham G. Engert A, Haverkamp H, Kobe C, Markova J, Renner C, Ho A. PD-1 blockade with nivolumab in relapsed or refractory Hodgkin's lymphoma [J]. Dose intensification with autologous bone-marrow transplantation in relapsed and resistant Hodgkin's disease: results of a BNLI randomised trial. 18F-FDG-PET/CT is standard to assess response in Hodgkin lymphoma by quantifying metabolic activity with the Deauville score. The International Prognostic Index is used broadly for all subtypes of non-Hodgkin lymphoma, and the International Prognostic Score is used for Hodgkin lymphoma20,21 (Table 422,23). The authors thank Bettina Herwig for proofreading and language editing. J. Clin. A 13-valent pneumococcal conjugate vaccine (Prevnar 13), followed by a 23-valent pneumococcal polysaccharide vaccine (Pneumovax 23) at least eight weeks later and then again at least five years later, should be administered following lymphoma treatment. Or Milgrom et al., who estimated the relapse rate of mediastinal Hodgkin Lymphoma by building a model with the five most predictive radiomic features from baseline PET scans, yielding promising AUCs13. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). In order to be human-readable, please install an RSS reader. and transmitted securely. However, the prognostic value Mol. The site is secure. The image biomarker standardization initiative: Standardized quantitative radiomics for high-throughput image-based phenotyping. ; methodology, F.I. Conceptualization, F.I. 10 Results showed superior results for patients who were PET negative. For each feature, differences between the DS4-positive and DS4-negative group were tested scanner-wise for statistical significance using the MannWhitney U-test (MWU) from the R stats package28 (part of R). The https:// ensures that you are connecting to the The Spearman between Deauville score and SUV max approach was 0.31 (95% CI, 0.230.38). PubMed Central Adenopathy can wax and wane over years in indolent presentations or involve rapidly progressive adenopathy in more aggressive subtypes. PET/CT (b,c) show this manifestation to be FDG-positive. ; Amthauer, H.; Mller, H.W. Disclaimer. 2016;17(9):1283-1294. Mixed cellularity Hodgkin can occur at any age, although it is most common in adults between the ages of 55 and 74, as well as children under the The National Comprehensive Cancer Network (NCCN) recommends avoiding certain chemotherapeutic agents in patients older than 60 years. Lambin, P. et al. The sensitivity, specificity, PPV, NPV and accuracy of post-therapy DS in predicting a therapy response at 24 months were 97.8%, 66.7%, 95.7%, 80.0% and 94.2%, respectively. WebInterim PET/CT scan was performed after 23 cycles of therapy, and the response was assessed using the Deauville 5-point scales (5-PS) and a semi-quantitative assessment using the SUVmax reduction rate (SUVmax). Target lesions were classified as Deauville score 4 positive (DS4+) or negative (DS4) based on their SUVpeak and then segmented in NECT images. Epub 2016 Jul 4. A metaanalysis of 18F-2-deoxy-2-fluoro-D-glucose positron emission tomography in the staging and restaging of patients with lymphoma. WebThe blood level of lactate dehydrogenase (LDH), which goes up with the amount of lymphoma in the body Each poor prognostic factor is assigned 1 point. EJNMMI Phys 7, 2. https://doi.org/10.1186/s40658-020-0270-y (2020). MeSH However, the prognostic value of residual metabolic tumor volume (rMTV) in patients with DS 4-5 has been less well characterized. Current paradigm of response to therapy in Hodgkins lymphoma. A DS of 3 or less is considered an adequate, and a DS of 4 or greater is considered an inadequate treatment response. Asthana, S.; Labani, S.; Mehrana, S.; Bakhshi, S. Incidence of childhood leukemia and lymphoma in India. ; Bernardo, M.P. Four patients were PET positive at the end of ABVD WebHe got quite a large lump on his right shoulder prior to chemotherapy and after the treatment, the lump could not be seen visibly. Rep. 6, 23428. https://doi.org/10.1038/srep23428 (2016). CAS WebRisk stratification on the basis of Deauville score on PET-CT and the presence of Epstein-Barr virus DNA after completion of primary treatment for extranodal natural killer/T-cell lymphomanasal typea multicentreretrospective analysis [J]. Correspondence to Finally, false-negative patients showed no residual disease at interim PET-CT, but evidence of disease at follow-up. To achieve reproducible results, we determined the final DS using the qPET approach23. Statistical analysis was performed using R (version 4.2.1, R Foundation for Statistical Computing)28. This site needs JavaScript to work properly. (Deauville score 1 to 2) interim PET/CT negative (Deauville score 3) interim PET/CT State after first-line standardized chemotherapy was based on the 5-Point Deauville Score. Korula A, Fouzia NA, Devasia A, Kulkarni U, Abraham A, Srivastava A. Bair SM, Svoboda J. Response-Adapted Treatment Strategies in Hodgkin Lymphoma Using PET Imaging. Open Access funding enabled and organized by Projekt DEAL. Marani C, Raiola AM, Morbelli S, Dominietto A, Ferrarazzo G, Avenoso D, Giannoni L, Varaldo R, Gualandi F, Grazia D, Lamparelli T, Bregante S, Van Lint MT, Ibatici A, Bovis F, Lemoli RM, Gobbi M, Bacigalupo A, Angelucci E. Biol Blood Marrow Transplant. 2016 Sep;95(9):1521-35. doi: 10.1007/s00277-016-2736-5. Google Scholar. The settings used for feature extraction can be found in the supplementary file S2a, the IBSI reporting guidelines and the checklist in the supplementary file S2b. J. Pers. Blautzik, J.; Grelich, L.; Schramm, N.; Henkel, R.; Bartenstein, P.; Pfluger, T. What and how should we measure in paediatric oncology FDG-PET/CT? https://doi.org/10.1038/s41598-022-24227-0, DOI: https://doi.org/10.1038/s41598-022-24227-0. Oncol. Score 3 should be interpreted according to the clinical context but in many Hodgkin Lymphoma patients indicates a good If not otherwise stated, the reading by S.N.N. Results: Among 212 scans assigned DS, 165 scans showed agreement between the DS and line of treatment. Our results should be verified in larger, more consistent patient populations examined on CT scanners from additional vendors to affirm median as a robust feature across scanners and should be validated externally according to Shahzadi44 supporting clinical applicability. J. Pers. The authors declare no competing interests. Get what matters in cancer research, free to your inbox weekly. 2022 Oct;29(10):6254-6264. doi: 10.1245/s10434-022-12191-y. Thank you for visiting nature.com. Akhtar S, Rauf SM, Elhassan TA, Maghfoor I. Ann Hematol. Performance of Philips Gemini TF PET/CT scanner with special consideration for its time-of-flight imaging capabilities. the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, Aleman, B.M.P. The resulting areas under the curve (AUCs) were rated as follows: 0.700.80 acceptable, 0.800.90 excellent, 0.901.00 outstanding diagnostic performance30. PubMed Central However, SUVmax did not predict the survival outcome using 59.8% of the optimal cutoff value. ; Beshir, M.R. and JavaScript. Lymphoma spreads to extranodal sites by direct invasion or by hematogenous spread to the spleen, liver, lungs, or bone marrow.14,15 High-grade lymphomas can present as oncologic emergencies because of the structural compression from the enlarging tumor, including superior vena cava syndrome, malignant epidural spinal cord compression, or malignant pericardial effusion.16 Paraneoplastic syndromes are rare with lymphoma, occurring as paraneoplastic cerebellar degeneration in Hodgkin lymphoma and as dermatomyositis and polymyositis in Hodgkin and non-Hodgkin lymphomas.17, The diagnosis of lymphoma is made using an open lymph node biopsy, based off morphology, immunohistochemistry, and flow cytometry.3 Although fine-needle aspiration and core needle biopsy are often part of the initial evaluation of any adenopathy, neither will provide adequate tissue for the diagnosis of lymphoma because of the need to verify Hodgkin lymphoma via the presence of Reed-Sternberg cells.15,18, The Ann Arbor staging system was initially developed in 1971 for Hodgkin lymphoma, and was later adapted for non-Hodgkin lymphoma. 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