Hutchings and Barrington Limited vs advanced stage HL: same criteria different cut off?
Early PET in limited stage HL
First group for early PET-response adapted lymphoma therapy although
Less data are available on the value of early PET than in advanced stage HL and aggressive NHL
Hutchings & Mikhaeel. Ann Oncol 2005
Hutchings et al. Blood 2006
57 stage I-II patients
31 stage I-IIA patients
Reasons for low PPV The disease has an inherently very good prognosis Most patients receive radiotherapy to the initially involved nodes ?
Early PET in advanced HL High NPV combined with High PPV - at least with ABVD
According to PET-2 (+vs.-) and IPS (0-2 vs 3-7)
Pre test likelihood of disease
Therapy BEACOPP ?
Disease type & stage
Post 2 or 4 ?
TIming
What do we want from test? High NPV desirable for de-escalation High PPV desirable for intensification Same criteria ? Different threshold
Meignan M, Gallamini A, Haioun C. Report on the first international workshop on interim-PET scan in lymphoma. Leuk.Lymphoma 2009;50:1257-1260.
Deauville criteria Score 1 no uptake Score 2 uptake ≤ mediastinum Score 3 uptake > mediastinum but ≤ liver Score 4 uptake > liver at any site Score 5 uptake > liver and new sites of disease Score X: new areas of uptake unlikely to be related to lymphoma
Meignan M, Gallamini A, Haioun C. Report on the first international workshop on interim-PET scan in lymphoma. Leuk.Lymphoma 2009;50:1257-1260.
Advanced stage criteria Score 1 no uptake Score 2 uptake ≤ mediastinum Score 3 uptake > mediastinum but ≤ liver Score 4: uptake > liver at any site Score 5 uptake > liver and new sites of disease Score X: new areas of uptake unlikely to be related to lymphoma
Early stage criteria Score 1 no uptake Score 2 uptake ≤ mediastinum Score 3 uptake > mediastinum but ≤ liver Score 4: uptake > liver at any site Score 5 uptake > liver and new sites of disease Score X: new areas of uptake unlikely to be related to lymphoma
Reporting
? ? ? ?
Limited vs advanced disease HD vs DLBCL Different therapy regimes De-escalation vs intensification Same criteria BUT different cut off
Image interpretation Standardisation of reporting Reproducibility Minimal residual uptake, however defined may have different significance according to ….
Staging and risk assessment of marginal zone lymphoma: ââ¦The value of positron emission ... MALT originating from the left lacrimal gland. PET-CT in MALT ...
published in Leukemia Lymphoma. ⢠Would the next step be :Imaging in ... lymphoma subtypes (FL,MCL,T-lymphoma ). 3. Identify key area of research in ...
if + (scores 4-5) or equivocal (score 3) then PET after 2 ABVD cycle. ⢠N=199 HL. 54 I-IIA .... Baseline MTV predictive of PFS and OS although tumor bulk was not.
FDG-PET after 2 cycles appears highly predictive, particularly for ... features (bulk, 3+ sites). ⢠All prognostic ... Assumptions: â 75% PET-negative after 2 ABVD.
Apr 9, 2010 - Haematology Torino and Rome. Second International workshop ... >No concomitant cardiac, liver, lung or renal disease. >HIV negativity, HCV ...
background activity to define PET positivity for a residual mass 2 cm in greatest transverse ... Volumetric analysis of tumour bulk and total tumour burden.
Apr 8, 2010 - Positivity/Reference background. â¢Nearby background. â¢Mediastinal blood pool ... On which curve is this patient? Significance of minimal ...
Therapy ABVD or EBVD x 6 ± consolidation or IF radiotherapy. Visual assessment: ... LYMPHOMA. 44 HIV-related HL patients enrolled in 9 European centers.
Oct 5, 2012 - MTV0 (⤠225 vs > 225) was predictive of 3-year progression free survival (3y-. PFS) (85% vs 42%; ...... Among 33 CSI/II pts, 21 (64%) actually ..... The average (median) time per scan upload and download were 13'23â (3'06â).
3rd International Workshop on Interim PET in Lymphoma. Menton, September 27, 2011. Poster Discussion. Poster discussion. NHL. Ulrich Dührsen. Department ...
RESULTS OF THE IELSG-26 STUDY. L. Ceriani *, M. Martelli, P.L. Zinzani, S. Govi, C. Stelitano, U. Vitolo,. E. Brusamolino, G. Cabras,L. Rigacci, M. Balzarotti, ...
The five-point visual assessment is applied as proposed at the Deauville consensus meeting. ⢠A cohort of ABVD-treated advanced-stage HL patients has been ...
Various Rent-A-Car Companies can be found in the airport such as: Ada, Avis, Budget, Europcar, Hertz,. National Citer and Sixt. ⢠13 connections by regular bus ...
However, need for additional markers to identify curable from refractory/fatal patients? Cured. Fatal. Need to improve IPI. ⢠Biomarkers with prognostic relevance.
