Assessment of Tumor Response to Therapy in Lymphoma Using $^{18}F$-FDG PET: Diagnostic Performance of $^{18}F$-FDG PET and Interval Likelihood Ratio PET and Interval Likelihood Ratio

$^{18}F$-FDG PET을 이용한 림프종 치료 반응 평가: $^{18}F$-FDG PET의 진단 성능 특성과 구간 우도비

  • Kim, Chang-Guhn (Department of Nuclear Medicine, Wonkwang University School of Medicine) ;
  • Kim, Dae-Weung (Department of Nuclear Medicine, Wonkwang University School of Medicine) ;
  • Park, Moo-Rim (Department of Internal Medicine, Wonkwang University School of Medicine)
  • 김창근 (원광대학교 의과대학 핵의학교실) ;
  • 김대응 (원광대학교 의과대학 핵의학교실) ;
  • 박무림 (원광대학교 의과대학 내과학교실)
  • Published : 2009.10.31

Abstract

In this paper, the authors intended to summarize briefly the features of lymphoma with regard to $^{18}F$-FDG PET for assessment of tumor response to therapy, to describe why assessment of treatment response should be performed, to review what method so far has been used in monitoring treatment response, to discuss what limitations of morphologic imaging criteria for assessing tumor response are, in compared with $^{18}F$-FDG PET, and to introduce recently proposed criteria for assessing tumor response in malignant lymphoma. And also the authors emphasize the need to understand the characteristics of diagnostic performance of $^{18}F$-FDG PET in several clinical settings in order to interpret $^{18}F$-FDG PET results appropriately, and to encourage the use of interval likelihood ratio to enhance clinical implications of test results which, in turns, allows referring physicians to understand the meaning of interpretation with easy. Until recently, treatment response has been assessed according to the morphologic criteria. Metabolic imaging with $^{18}F$-FDG PET was adopted to have important role for treatment assessment in IWC+PET criteria proposed recently by IHP. To accomplish this role, we should perform and interpret $^{18}F$-FDG PET according to IWC+PET criteria. It is important for referring physicians to understand the various limitations of $^{18}F$-FDG PET and pitfalls in PET interpretation, and to understand that clinical information are needed by nuclear medicine physicians to optimize the interpretation of $^{18}F$-FDG PET.

Keywords

References

  1. Swerdlow SH. WHO Classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon: IARC; 2008. p. 158-319
  2. Fauci AS. Harrison's principles of internal medicine. 17th ed. Seoul: McGrowHill; 2008. p. 688
  3. Lister TA, Crowther D, Sutcliffe SB, Glatstein E, Canellos GP, Young RC, et al. Report of a committee convened to discuss the evaluation and staging of patients with Hodgkin's disease: Cotswolds meeting. J Clin Oncol 1989;7:1630-6 https://doi.org/10.1200/JCO.1989.7.11.1630
  4. A predictive model for aggressive non-Hodgkin's lymphoma The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med 1993;329:987-94 https://doi.org/10.1056/NEJM199309303291402
  5. Hasenclever D, Diehl V. A. prognostic score for advanced Hodgkin's disease. International Prognostic Factors Project on Advanced Hodgkin's Disease. N Engl J Med 1998;339:1506-14 https://doi.org/10.1056/NEJM199811193392104
  6. Gallamini A, Hutchings M, Rigacci L, Specht L, Merli F, Hansen M, et al. Early interim 2-[$^{18}$F]fluoro-2-deoxy-{).glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma: a report from a joint Italian-Danish study. J Clin Oncol 2007;25:3746-52 https://doi.org/10.1200/JCO.2007.11.6525
  7. Spaepen K, Stroobants S, Dupont P, Vandenberghe P, Thomas J, de Groot T, et al. Early restaging positron emission tomography with (18)F-fluorodeoxyglucose predicts outcome in patients with aggressive non-Hodgkin's lymphoma. Ann Oncol 2002;13:1356-63 https://doi.org/10.1093/annonc/mdf256
  8. Miller AB, Hoogstraten B, Staquet M, Winkler A. Reporting results of cancer treatment. Cancer 1981;47:207-14 https://doi.org/10.1002/1097-0142(19810101)47:1<207::AID-CNCR2820470134>3.0.CO;2-6
  9. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000;92:205-16 https://doi.org/10.1093/jnci/92.3.205
  10. Young H, Baum R, Cremerius U, Herholz K, Hoekstra O, Lammertsma AA, et al. Measurement of clinical and subclinical tumour response using [$^{18}$F]-fluorodeoxyglucose and positron emission tomography: review and 1999 EORTC recommendations. European Organization for Research and Treatment of Cancer (EORTC) PET Study Group. Eur J Cancer 1999;35:1773-82 https://doi.org/10.1016/S0959-8049(99)00229-4
  11. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009;45:228-47 https://doi.org/10.1016/j.ejca.2008.10.026
  12. Wahl RL, Jacene H, Kasamon Y, Lodge MA. From RECIST to PERCIST: Evolving Considerations for PET response criteria in solid tumors. J Nucl Med 2009;50S:122S-50S
  13. Cheson BD, Homing SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999;17:1244
  14. Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al. Revised response criteria for malignant lymphoma. J Clin Oncol 2007;25:579-86 https://doi.org/10.1200/JCO.2006.09.2403
  15. Juweid ME, Stroobants S, Hoekstra OS, Mottaghy FM, Dietlein M, Guermazi A, et al. Use of positron emission tomography for response assessment of lymphoma: consensus of the Imaging Subcommittee of International Harmonization Project in Lymphoma. J Clin Oncol 2007;25:571-8 https://doi.org/10.1200/JCO.2006.08.2305
  16. Canellos GP. Residual mass in lymphoma may not be residual disease. J Clin Oncol 1988;6:931-3 https://doi.org/10.1200/JCO.1988.6.6.931
  17. Kasamon YL, Wahl RL. FDG PET and risk-adapted therapy in Hodgkin's and non-Hodgkin's lymphoma. Curr Opin Oncol 2008;20:206-19 https://doi.org/10.1097/CCO.0b013e3282f5123d