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Influence of Software Tool and Methodological Aspects of Total Metabolic Tumor Volume Calculation on Baseline [18F]FDG PET to Predict Survival in Hodgkin Lymphoma.

Kanoun S, Tal I, Berriolo-Riedinger A, Rossi C, Riedinger JM, Vrigneaud JM, Legrand L, Humbert O, Casasnovas O, Brunotte F, Cochet A - PLoS ONE (2015)

Bottom Line: There was no significant difference between ROC curves.High TMTV0 value was predictive of poor PFS in all methodologies: 4-years PFS was 83% vs 42% (p = 0.006) for TMTV02.5, 83% vs 41% (p = 0.003) for TMTV041, 85% vs 40% (p<0.001) for TMTV0125 and 83% vs 42% (p = 0.004) for TMTV0140.However, no significant differences were found in term of prognosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France; Le2i UMR CNRS 6306, Dijon, France; MRI Unit, Centre Hospitalier Régional Universitaire, Hôpital Le Bocage, Dijon, France.

ABSTRACT

Aim: To investigate the respective influence of software tool and total metabolic tumor volume (TMTV0) calculation method on prognostic stratification of baseline 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]FDG-PET) in newly diagnosed Hodgkin lymphoma (HL).

Methods: 59 patients with newly diagnosed HL were retrospectively included. [18F]FDG-PET was performed before any treatment. Four sets of TMTV0 were calculated with Beth Israel (BI) software: based on an absolute threshold selecting voxel with standardized uptake value (SUV) >2.5 (TMTV02.5), applying a per-lesion threshold of 41% of the SUV max (TMTV041) and using a per-patient adapted threshold based on SUV max of the liver (>125% and >140% of SUV max of the liver background; TMTV0125 and TMTV0140). TMTV041 was also determined with commercial software for comparison of software tools. ROC curves were used to determine the optimal threshold for each TMTV0 to predict treatment failure.

Results: Median follow-up was 39 months. There was an excellent correlation between TMTV041 determined with BI and with the commercial software (r = 0.96, p<0.0001). The median TMTV0 value for TMTV041, TMTV02.5, TMTV0125 and TMTV0140 were respectively 160 (used as reference), 210 ([28;154] p = 0.005), 183 ([-4;114] p = 0.06) and 143 ml ([-58;64] p = 0.9). The respective optimal TMTV0 threshold and area under curve (AUC) for prediction of progression free survival (PFS) were respectively: 313 ml and 0.70, 432 ml and 0.68, 450 ml and 0.68, 330 ml and 0.68. There was no significant difference between ROC curves. High TMTV0 value was predictive of poor PFS in all methodologies: 4-years PFS was 83% vs 42% (p = 0.006) for TMTV02.5, 83% vs 41% (p = 0.003) for TMTV041, 85% vs 40% (p<0.001) for TMTV0125 and 83% vs 42% (p = 0.004) for TMTV0140.

Conclusion: In newly diagnosed HL, baseline metabolic tumor volume values were significantly influenced by the choice of the method used for determination of volume. However, no significant differences were found in term of prognosis.

No MeSH data available.


Related in: MedlinePlus

PFS survival according to methodologies.PFS survival analysis according to TMTV02.5 (a), TMTV041 (b), TMTV0125 (c), and TMTV0140 (d).
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pone.0140830.g006: PFS survival according to methodologies.PFS survival analysis according to TMTV02.5 (a), TMTV041 (b), TMTV0125 (c), and TMTV0140 (d).

Mentions: All the tested TMTV0 methodologies were predictive of PFS (Fig 6). Patients having a high TMTV0 according to the previously defined cut-off for each methodology had a significant poorer prognosis. 4-years PFS was 83% vs 42% (p = 0.006) for TMTV02.5, 83% vs 41% (p = 0.003) for TMTV041, 85% vs 40% (p<0.001) for TMTV0125 and 83% vs 42% (p = 0.004) TMTV0140. Results of the Cox proportional hazards regression models for prediction of PFS are reported in Table 2. Only factors having a p value less than 0.1 in univariate analysis on the log-rank test were included. The TMTV0 remained an independent predictor of event, whatever the method of computation used, even when adjusted for IPS and presence of bulky disease.


Influence of Software Tool and Methodological Aspects of Total Metabolic Tumor Volume Calculation on Baseline [18F]FDG PET to Predict Survival in Hodgkin Lymphoma.

Kanoun S, Tal I, Berriolo-Riedinger A, Rossi C, Riedinger JM, Vrigneaud JM, Legrand L, Humbert O, Casasnovas O, Brunotte F, Cochet A - PLoS ONE (2015)

PFS survival according to methodologies.PFS survival analysis according to TMTV02.5 (a), TMTV041 (b), TMTV0125 (c), and TMTV0140 (d).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4608733&req=5

pone.0140830.g006: PFS survival according to methodologies.PFS survival analysis according to TMTV02.5 (a), TMTV041 (b), TMTV0125 (c), and TMTV0140 (d).
Mentions: All the tested TMTV0 methodologies were predictive of PFS (Fig 6). Patients having a high TMTV0 according to the previously defined cut-off for each methodology had a significant poorer prognosis. 4-years PFS was 83% vs 42% (p = 0.006) for TMTV02.5, 83% vs 41% (p = 0.003) for TMTV041, 85% vs 40% (p<0.001) for TMTV0125 and 83% vs 42% (p = 0.004) TMTV0140. Results of the Cox proportional hazards regression models for prediction of PFS are reported in Table 2. Only factors having a p value less than 0.1 in univariate analysis on the log-rank test were included. The TMTV0 remained an independent predictor of event, whatever the method of computation used, even when adjusted for IPS and presence of bulky disease.

Bottom Line: There was no significant difference between ROC curves.High TMTV0 value was predictive of poor PFS in all methodologies: 4-years PFS was 83% vs 42% (p = 0.006) for TMTV02.5, 83% vs 41% (p = 0.003) for TMTV041, 85% vs 40% (p<0.001) for TMTV0125 and 83% vs 42% (p = 0.004) for TMTV0140.However, no significant differences were found in term of prognosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France; Le2i UMR CNRS 6306, Dijon, France; MRI Unit, Centre Hospitalier Régional Universitaire, Hôpital Le Bocage, Dijon, France.

ABSTRACT

Aim: To investigate the respective influence of software tool and total metabolic tumor volume (TMTV0) calculation method on prognostic stratification of baseline 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]FDG-PET) in newly diagnosed Hodgkin lymphoma (HL).

Methods: 59 patients with newly diagnosed HL were retrospectively included. [18F]FDG-PET was performed before any treatment. Four sets of TMTV0 were calculated with Beth Israel (BI) software: based on an absolute threshold selecting voxel with standardized uptake value (SUV) >2.5 (TMTV02.5), applying a per-lesion threshold of 41% of the SUV max (TMTV041) and using a per-patient adapted threshold based on SUV max of the liver (>125% and >140% of SUV max of the liver background; TMTV0125 and TMTV0140). TMTV041 was also determined with commercial software for comparison of software tools. ROC curves were used to determine the optimal threshold for each TMTV0 to predict treatment failure.

Results: Median follow-up was 39 months. There was an excellent correlation between TMTV041 determined with BI and with the commercial software (r = 0.96, p<0.0001). The median TMTV0 value for TMTV041, TMTV02.5, TMTV0125 and TMTV0140 were respectively 160 (used as reference), 210 ([28;154] p = 0.005), 183 ([-4;114] p = 0.06) and 143 ml ([-58;64] p = 0.9). The respective optimal TMTV0 threshold and area under curve (AUC) for prediction of progression free survival (PFS) were respectively: 313 ml and 0.70, 432 ml and 0.68, 450 ml and 0.68, 330 ml and 0.68. There was no significant difference between ROC curves. High TMTV0 value was predictive of poor PFS in all methodologies: 4-years PFS was 83% vs 42% (p = 0.006) for TMTV02.5, 83% vs 41% (p = 0.003) for TMTV041, 85% vs 40% (p<0.001) for TMTV0125 and 83% vs 42% (p = 0.004) for TMTV0140.

Conclusion: In newly diagnosed HL, baseline metabolic tumor volume values were significantly influenced by the choice of the method used for determination of volume. However, no significant differences were found in term of prognosis.

No MeSH data available.


Related in: MedlinePlus