Optimización de los criterios metabólicos en la valoración pronóstica de los pacientes con linfoma. Estudio multicéntrico / Optimisation of metabolic criteria in the prognostic assessment in patients with lymphoma. A multicentre study

Objetivo: Comparar sensibilidad, especificidad y valor pronóstico de Deauville score (DS) versus ΔSUVmax, tanto en «interim» PET (iPET) como en «end» PET (ePET), en pacientes con linfoma difuso de células grandes B (LDCGB), linfoma de Hodgkin (LH), linfoma folicular (LF). Método: Estudio multicéntrico retrospectivo longitudinal en 138 pacientes (46 LDCGB, 46 LH, 46 LF). Se realizaron 3 18F-FDG PET/TC: basal, iPET y ePET. En iPET y ePET se utilizaron 2 criterios de interpretación: visual (DS) y semicuantitativo (ΔSUVmax). Se estableció el valor pronóstico en relación con el intervalo libre de enfermedad. Resultados: Análisis estadístico. Del iPET por subtipos histológicos (LDCGB, LH y LF): 1) DS obtuvo sensibilidad 76,92/83,33/61,53%; especificidad 78,78/85/81,81%, respectivamente; 2) ΔSUVmax obtuvo una sensibilidad del 53,84/83,33/61,53%; especificidad del 87,87/87,50/78,78%. Del ePET por subtipos histológicos: 1) DS obtuvo sensibilidad del 61,53/83,33/69,23%; especificidad del 90,90/85/87,87%; 2) ΔSUVmax obtuvo sensibilidad del 69,23/83,33/69,23%; especificidad del 90,90/87,5/84,84%. Evaluación pronóstica. Estudio iPET: en LDCGB el DS obtuvo que 10,3% con iPET negativo recidivó durante el intervalo libre de enfermedad y 17,1% con ΔSUVmax; en LH ambos métodos obtuvieron que 2,8% con iPET negativo recidivó; en LF el DS obtuvo que 15,6% con iPET negativo recidivó, con ΔSUVmax 16,1%, sin significación estadística para este método. Estudio ePET: en LDCGB el DS obtuvo que 14,3% con ePET negativo recidivó durante el intervalo libre de enfermedad, respecto al 11,8% con ΔSUVmax; en LH y LF ambos métodos obtuvieron que 2,8 y 12,5%, respectivamente, con ePET negativo recidivó. Conclusión: DS y ΔSUVmax no muestran diferencias significativas en LDCGB, LH, LF. El valor pronóstico del DS y ΔSUVmax no muestra diferencias significativas en LH y LF; en LDCGB el DS es superior en iPET y el ΔSUVmax en ePET (AU)

Objective: To compare sensitivity, specificity and predictive value of Deauville score (DS) vs. ΔSUVmax in interim-treatment PET (iPET) and end-treatment PET (ePET), in patients with diffuse large B cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and follicular lymphoma (FL). Method: Retrospective longitudinal multicentre study including 138 patients (46 DLBCL, 46 HL, 46 FL), on whom 3 18F-FDG PET/CT were performed: baseline, iPET, and ePET. Visual (DS) and semi-quantitative (ΔSUVmax) parameters were determined for iPET and ePET. Predictive value was determined in relation to disease-free interval. Results: Statistical analysis. iPET for DLBCL, HL, and FL: 1) sensitivity of DS: 76.92/83.33/61.53%; specificity: 78.78/85/81.81%; 2) sensitivity of ΔSUVmax: 53.84/83.33/61.53%; specificity: 87.87/87.50/78.78%. ePET for DLBCL, HL and FL: 1) sensitivity of DS: 61.53/83.33/69.23%; specificity: 90.90/85/87.87%; 2) sensitivity of ΔSUVmax: 69.23/83.33/69.23%; specificity: 90.90/87.50/84.84%. Predictive assessment. iPET study: in DLBCL, DS resulted in 10.3% recurrence of negative iPET, and 17.1% in ΔSUVmax at disease-free interval; in HL, both parameters showed a 2.8% recurrence of negative iPET; in FL, DS resulted in 15.6% recurrence of negative iPET, and 16.1% in ΔSUVmax, with no statistical significance. ePET study: in DLBCL, DS resulted in 14.3% recurrence of negative ePET, and 11.8% in ΔSUVmax at disease-free interval; in HL and FL, both methods showed 2.8 and 12.5% recurrence in negative ePET, respectively. Conclusion: DS and ΔSUVmax did not show significant differences in DLBCL, HL and FL. Their predictive value also did not show significant differences in HL and FL. In DLBCL, DS was higher in iPET, and ΔSUVmax in ePET (AU)

Optimisation of metabolic criteria in the prognostic assessment in patients with lymphoma. A multicentre study. / Optimización de los criterios metabólicos en la valoración pronóstica de los pacientes con linfoma. Estudio multicéntrico.

OBJECTIVE: To compare sensitivity, specificity and predictive value of Deauville score (DS) vs. ΔSUVmax in interim-treatment PET (iPET) and end-treatment PET (ePET), in patients with diffuse large B cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and follicular lymphoma (FL). METHOD: Retrospective longitudinal multicentre study including 138 patients (46 DLBCL, 46 HL, 46 FL), on whom 3 18F-FDG PET/CT were performed: baseline, iPET, and ePET. Visual (DS) and semi-quantitative (ΔSUVmax) parameters were determined for iPET and ePET. Predictive value was determined in relation to disease-free interval. RESULTS: Statistical analysis. iPET for DLBCL, HL, and FL: 1) sensitivity of DS: 76.92/83.33/61.53%; specificity: 78.78/85/81.81%; 2) sensitivity of ΔSUVmax: 53.84/83.33/61.53%; specificity: 87.87/87.50/78.78%. ePET for DLBCL, HL and FL: 1) sensitivity of DS: 61.53/83.33/69.23%; specificity: 90.90/85/87.87%; 2) sensitivity of ΔSUVmax: 69.23/83.33/69.23%; specificity: 90.90/87.50/84.84%. Predictive assessment. iPET study: in DLBCL, DS resulted in 10.3% recurrence of negative iPET, and 17.1% in ΔSUVmax at disease-free interval; in HL, both parameters showed a 2.8% recurrence of negative iPET; in FL, DS resulted in 15.6% recurrence of negative iPET, and 16.1% in ΔSUVmax, with no statistical significance. ePET study: in DLBCL, DS resulted in 14.3% recurrence of negative ePET, and 11.8% in ΔSUVmax at disease-free interval; in HL and FL, both methods showed 2.8 and 12.5% recurrence in negative ePET, respectively. CONCLUSION: DS and ΔSUVmax did not show significant differences in DLBCL, HL and FL. Their predictive value also did not show significant differences in HL and FL. In DLBCL, DS was higher in iPET, and ΔSUVmax in ePET.