FDG PET for therapy monitoring in Hodgkin’s and non-Hodgkin’s lymphomas: qPET versus rPET

@article{Laffon2017FDGPF,
  title={FDG PET for therapy monitoring in Hodgkin’s and non-Hodgkin’s lymphomas: qPET versus rPET},
  author={Eric Laffon and Roger Marthan},
  journal={European Journal of Nuclear Medicine and Molecular Imaging},
  year={2017},
  volume={44},
  pages={1602-1603}
}
  • E. Laffon, R. Marthan
  • Published 18 May 2017
  • Medicine
  • European Journal of Nuclear Medicine and Molecular Imaging
Dear Sir, Barrington and Kluge [1] recently reviewed the role of FDG-PET imaging for therapy monitoring in Hodgkin’s and non-Hodgkin’s lymphomas (HL and NHL) and emphasized the importance of understanding the Deauville five-point scale (5p-DS) in interim PET scans. Deauville criteria (DC) rely on a simple visual analysis that compares residual uptake with that of two reference tissues, mediastinum and liver. These authors also commented on a quantitative extension of the DC proposed by… 
Reply to: Laffon and Marthan “FDG PET for therapy monitoring in Hodgkin’s and non-Hodgkin’s lymphomas: qPET versus rPET”
TLDR
The wrong impression that the q PET method is not quantitative may have resulted from a further advantage of the qPET method, namely that, as described in the original paper, qPET signals can be translated into the currently established international standard – the Deauville score.
Measurement uncertainty and clinical impact of target-to-background ratios derived by interim FDG-PET/CT in Hodgkin lymphoma: reply to Laffon and Martan
Dear Sir, Interim FDG-PET/CT imaging performed after the first two cycles of chemotherapy and visually evaluated by Deauville criteria (DS) has proved to be the best prognostic tool in patients with
An evaluation of brentuximab vedotin as a treatment option for stage III/IV Hodgkin lymphoma
TLDR
The role of brentuximab vedotin in the upfront treatment of advanced stage classical Hodgkin lymphoma is summarized in the context of reducing therapy-related toxicity without compromising the high cure rate.

References

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FDG PET for therapy monitoring in Hodgkin and non-Hodgkin lymphomas
TLDR
Quantitative methods to perform PET in standardized ways have also been developed which may further improve response assessment including a quantitative extension to the DC (qPET), which may have advantages in providing a continuous scale to refine the threshold for adequate/inadequate response in specific clinical situations or treatment optimization in trials.
Interim FDG-PET/CT in Hodgkin lymphoma: the prognostic role of the ratio between target lesion and liver SUVmax (rPET)
TLDR
rPET could be considered an accurate prognostic factor in patients with HL undergoing interim FDG-PET/CT and to compare rPET with the 5-point Deauville Score.
qPET – a quantitative extension of the Deauville scale to assess response in interim FDG-PET scans in lymphoma
TLDR
qPET methodology provides semi-automatic quantification for interim FDG-PET response in lymphoma extending ordinal Deauville scoring to a continuous scale without need for follow-up data.
Sources of variability in FDG PET imaging and the qPET value: reply to Laffon and Marthan
TLDR
In their letter, Laffon and Marthan correctly point out that the acquisition variability is not yet well investigated and certainly not negligible and an ideal study to assess this variance component would require patients to undergo FDG PET imaging in different institutions on successive days.
Baseline Metabolic Tumor Volume Predicts Outcome in High-Tumor-Burden Follicular Lymphoma: A Pooled Analysis of Three Multicenter Studies.
TLDR
Baseline TMTV is a strong independent predictor of outcome in FL and warrants further validation as a biomarker for development of first-line PET-adapted approaches in FL.
Interim FDG PET scans in lymphoma: SUV measurement error may impair qPET methodology
TLDR
The above calculated estimation indicates that SUV MEr may impair qPET methodology and it is suggested that qPET variability should be specifically investigated in a series of lymphoma patients.
Measurement uncertainty of lesion and reference mediastinum standardized uptake value in lung cancer
TLDR
Comparison between target lesion SUV and reference mediastinum SUV must take into account SUV MU of both, and no MU reduction can be expected from using the lesion/mediast inum SUVmax ratio instead of Lesion-SUVmax.