[ Special series on Lymphoma ]
doi: 10.1186/s40880-015-0021-y
Qualitative visual trichotomous assessment improves the value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in predicting the prognosis of diffuse large B-cell lymphoma
Xu Zhang, Wei Fan, Ying-Ying Hu, Zhi-Ming Li, Zhong-Jun Xia, Xiao-Ping Lin, Ya-Rui Zhang, Pei-Yan Liang and Yuan-Hua Li
Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine; Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong, P. R. China
[Abstract]
Introduction
Fluorine-18 fluorodeoxyglucose (18?F-FDG) positron emission tomography/computed tomography (PET/CT) is a powerful tool for monitoring the response of diffuse large B-cell lymphoma (DLBCL) to therapy, but the criteria to interpret PET/CT results remain under debate. We investigated the value of post-treatment PET/CT in predicting the prognosis of DLBCL patients when interpreted according to qualitative visual trichotomous assessment (QVTA) criteria compared with the Deauville criteria.
Methods
In this retrospective study, final PET/CT scans of DLBCL patients treated with rituximab-based regimens between October 2005 and November 2010 were interpreted using the Deauville and QVTA criteria. Survival curves were estimated using Kaplan-Meier analysis and compared using the log-rank test.
Results
A total of 253 patients were enrolled. The interpretation according to the Deauville criteria revealed that 181 patients had negative PET/CT scan results and 72 had positive results. The 3 year overall survival (OS) rate was significantly higher in patients with negative scan results than in those with positive results (91.6 % vs. 57.5 %, P<0.001). The 72 patients with positive scan results according to the Deauville criteria were divided into two groups by the interpretation according to the QVTA criteria: 29 had indeterminate results, and 43 had positive results. The 3 year OS rate was significantly higher in patients with indeterminate scan results than in those with positive results (91.2 % vs. 33.5 %, P<0.001) but was similar between patients with negative and indeterminate scan results (91.6 % vs. 91.2 %, P=0.921).
Conclusions
Compared with the Deauville criteria, using the QVTA criteria for interpreting post-treatment PET/CT scans of DLBCL patients is likely to reduce the number of false positive results. The QVTA criteria are feasible for therapeutic outcome evaluation and can be used to guide risk-adapted therapy.
Introduction
Fluorine-18 fluorodeoxyglucose (18?F-FDG) positron emission tomography/computed tomography (PET/CT) is a powerful tool for monitoring the response of diffuse large B-cell lymphoma (DLBCL) to therapy, but the criteria to interpret PET/CT results remain under debate. We investigated the value of post-treatment PET/CT in predicting the prognosis of DLBCL patients when interpreted according to qualitative visual trichotomous assessment (QVTA) criteria compared with the Deauville criteria.
Methods
In this retrospective study, final PET/CT scans of DLBCL patients treated with rituximab-based regimens between October 2005 and November 2010 were interpreted using the Deauville and QVTA criteria. Survival curves were estimated using Kaplan-Meier analysis and compared using the log-rank test.
Results
A total of 253 patients were enrolled. The interpretation according to the Deauville criteria revealed that 181 patients had negative PET/CT scan results and 72 had positive results. The 3 year overall survival (OS) rate was significantly higher in patients with negative scan results than in those with positive results (91.6 % vs. 57.5 %, P<0.001). The 72 patients with positive scan results according to the Deauville criteria were divided into two groups by the interpretation according to the QVTA criteria: 29 had indeterminate results, and 43 had positive results. The 3 year OS rate was significantly higher in patients with indeterminate scan results than in those with positive results (91.2 % vs. 33.5 %, P<0.001) but was similar between patients with negative and indeterminate scan results (91.6 % vs. 91.2 %, P=0.921).
Conclusions
Compared with the Deauville criteria, using the QVTA criteria for interpreting post-treatment PET/CT scans of DLBCL patients is likely to reduce the number of false positive results. The QVTA criteria are feasible for therapeutic outcome evaluation and can be used to guide risk-adapted therapy.
Chinese Journal of Cancer 2015, Volume: 34, Issue 6
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Xu Zhang, Wei Fan, Ying-Ying Hu, Zhi-Ming Li, Zhong-Jun Xia, Xiao-Ping Lin, Ya-Rui Zhang, Pei-Yan Liang and Yuan-Hua Li. Qualitative visual trichotomous assessment improves the value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in predicting the prognosis of diffuse large B-cell lymphoma. Chin J Cancer. 2015, 34:20. doi:10.1186/s40880-015-0021-y
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[ Html full-text / Citation export] (BioMed Central)
[Google Scholar]
[ More articles of the special series on Lymphoma ]
Cite this article
Xu Zhang, Wei Fan, Ying-Ying Hu, Zhi-Ming Li, Zhong-Jun Xia, Xiao-Ping Lin, Ya-Rui Zhang, Pei-Yan Liang and Yuan-Hua Li. Qualitative visual trichotomous assessment improves the value of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in predicting the prognosis of diffuse large B-cell lymphoma. Chin J Cancer. 2015, 34:20. doi:10.1186/s40880-015-0021-y
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