Predictive value of baseline metabolic tumor volume in early-stage favorable Hodgkin Lymphoma – Data from the prospective, multicenter phase III HD16 trial
Lutz van Heek,
Colin Stuka,
Helen Kaul,
Horst Müller,
Jasmin Mettler,
Felicitas Hitz,
Christian Baues,
Michael Fuchs,
Peter Borchmann,
Andreas Engert,
Markus Dietlein,
Conrad-Amadeus Voltin,
Carsten Kobe
Affiliations
Lutz van Heek
Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne
Colin Stuka
Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne
Helen Kaul
First Department of Internal Medicine and German Hodgkin Study Group (GHSG), Center for Integrated Oncology Aachen – Bonn – Cologne – Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne
Horst Müller
First Department of Internal Medicine and German Hodgkin Study Group (GHSG), Center for Integrated Oncology Aachen – Bonn – Cologne – Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne
Jasmin Mettler
Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne
Felicitas Hitz
Swiss Group for Clinical Cancer Research
Christian Baues
Department of Radiation Oncology and Cyberknife Center, Faculty of Medicine and UniversityHospital Cologne, University of Cologne
Michael Fuchs
First Department of Internal Medicine and German Hodgkin Study Group (GHSG), Center for Integrated Oncology Aachen – Bonn – Cologne – Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne
Peter Borchmann
First Department of Internal Medicine and German Hodgkin Study Group (GHSG), Center for Integrated Oncology Aachen – Bonn – Cologne – Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne
Andreas Engert
First Department of Internal Medicine and German Hodgkin Study Group (GHSG), Center for Integrated Oncology Aachen – Bonn – Cologne – Düsseldorf (CIO ABCD), Faculty of Medicine and University Hospital Cologne, University of Cologne
Markus Dietlein
Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne
Conrad-Amadeus Voltin
Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne
Carsten Kobe
Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne
Abstract Background 18F -fluorodeoxyglucose (FDG) positron emission tomography (PET) plays an important role in the staging and response assessment of lymphoma patients. Our aim was to explore the predictive relevance of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with early stage Hodgkin lymphoma treated within the German Hodgkin Study Group HD16 trial. Methods 18F-FDG PET/CT images were available for MTV and TLG analysis in 107 cases from the HD16 trial. We calculated MTV and TLG using three different threshold methods (SUV4.0, SUV41% and SUV140%L), and then performed receiver-operating-characteristic analysis to assess the predictive impact of these parameters in predicting an adequate therapy response with PET negativity after 2 cycles of chemotherapy. Results All three threshold methods analyzed for MTV and TLG calculation showed a positive correlation with the PET response after 2 cycles chemotherapy. The largest area under the curve (AUC) was observed using the fixed threshold of SUV4.0 for MTV- calculation (AUC 0.69 [95% CI 0.55–0.83]) and for TLG-calculation (AUC 0.69 [0.55–0.82]). The calculations for MTV and TLG with a relative threshold showed a lower AUC: using SUV140%L AUCs of 0.66 [0.53–0.80] for MTV and 0.67 for TLG [0.54–0.81]) were observed, while with SUV41% an AUC of 0.61 [0.45–0.76] for MTV, and an AUC 0.64 [0.49–0.80]) for TLG were seen. Conclusions MTV and TLG do have a predictive value after two cycles ABVD in early stage Hodgkin lymphoma, particularly when using the fixed threshold of SUV4.0 for MTV and TLG calculation. Trial registration ClinicalTrials.gov NCT00736320 .
