Concordance in the interpretation of PET after chemotherapy in advanced stage Hodgkin lymphoma

被引:6
作者
Kobe, C. [1 ]
Kuhnert, G. [1 ]
Haverkamp, H. [2 ]
Fuchs, M. [2 ,3 ]
Kahraman, D. [1 ]
Eich, H. -T. [2 ,4 ]
Kriz, J. [2 ,4 ]
Baues, C. [5 ]
Nast-Kolb, B. [5 ]
Broeckelmann, P. J. [2 ,3 ]
Borchmann, P. [2 ,3 ]
Drzezga, A. [1 ]
Engert, A. [2 ,3 ]
Dietlein, M. [1 ]
机构
[1] Univ Hosp Cologne, Dept Nucl Med, D-50937 Cologne, Germany
[2] Univ Hosp Cologne, German Hodgkin Study Grp, Cologne, Germany
[3] Univ Hosp Cologne, Dept Internal Med 1, Cologne, Germany
[4] Univ Hosp Munster, Dept Radiat Oncol, Munster, Germany
[5] Univ Hosp Cologne, Dept Radiat Oncol, Cologne, Germany
来源
NUKLEARMEDIZIN-NUCLEAR MEDICINE | 2015年 / 54卷 / 06期
关键词
PET; interpretation; concordance; Hodgkin lymphoma; POSITRON-EMISSION-TOMOGRAPHY; QUALITY-ASSURANCE PROGRAM; STUDY-GROUP GHSG; RESPONSE ASSESSMENT; OPEN-LABEL; INTERIM; RADIOTHERAPY; CONSENSUS; CRITERIA; ABVD;
D O I
10.3413/Nukmed-0746-15-06
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The aim was to analyze the degree of agreement between the central review panel and the local PET interpretation within the HD15 trial and its impact on subsequent treatment and progression free survival. Patients, methods: The analysis set consisted of 739 patients with residues >= 2.5 cm after 6 or 8 cycles of BEACOPPesc from the HD15 trial performed by the German Hodgkin Study Group. The recommendation for or against further radiotherapy was based on the central [F-18] FDG-PET interpretation. Central PET interpretation was compared to the local PET interpretation and concordance was measured using Cohen's Kappa coefficient. Prognostic impact of the analysis of concordance between local and central PET interpretations was evaluated using progression free survival (PFS); groups were compared with the log rank test. Results: The central panel rated 548 of 739 patients (74%) as PET negative. Of these, 513 were also rated as PET negative in the local PET interpretation. PET positivity was seen by central reviewers in the remaining 191 patients (26%), in concordance with local reviewers in 155 cases. Even though substantial agreement was found (Cohen's Kappa 0.81), the interpretation of the central PET review panel led to a different therapeutic recommendation in 71/739 (10%) patients. PFS was equally high in groups in which the therapeutic regime had been changed on the basis of the central panel decision. Conclusion: High concordance is found between local and central reviewers with regard to PET interpretation in residual tissue after intense chemotherapy. The existence of the central PET review panel allows the identification of additional patients as PET negative so that radiotherapy can be safely omitted (35 of 548 patients = 4.7%).
引用
收藏
页码:241 / 246
页数:6
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