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Poor predictive value of positive interim FDG-PET/CT in primary mediastinal large B-cell lymphoma

  • Julien Lazarovici
  • Marie Terroir
  • Julia Arfi-Rouche
  • Jean-Marie Michot
  • Sacha Mussot
  • Valentina Florea
  • Maria-Rosa Ghigna
  • Peggy Dartigues
  • Cynthia Petrovanu
  • Alina Danu
  • Christophe Fermé
  • Vincent Ribrag
  • David Ghez
Original Article

Abstract

Purpose

Though commonly used to assess response to therapy, the prognostic value of interim FDG-PET/CT in Primary Mediastinal Large B-cell Lymphoma (PMBCL) is unclear.

Methods

We conducted a retrospective study on 36 consecutive patients treated at our institution for a PMBCL between 2006 and 2014. All patients with a positive interim FDG-PET/CT had undergone histological restaging consisting either in a surgical debulking of the residual lesion (15 patients) or a CT-guided core needle biopsy (two patients). All FDG-PET/CT were secondarily reviewed according to the more recent Deauville criteria.

Results

Interim FDG-PET/CT was considered positive in 17/36 patients using visual evaluation. Among these patients, 14 had a Deauville score of 4. Histological restaging was negative in all but one case, showing inflammation and/or fibrosis. After a median follow-up of 48.5 months, a total of five patients have relapsed, two patients in the positive FDG-PET/CT group, and three patients in the negative FDG-PET/CT group, respectively.

Conclusions

These data indicate that a positive interim FDG-PET/CT does not reflect persistence of active disease in the vast majority of PMBCL cases. The relapse rate appears similar regardless of interim FDG-PET/CT results and interpretation criteria. This suggests that interim FDG-PET/CT has a poor positive predictive value, thus kt should be used with caution in PMBCL.

Keywords

18FDG pet/Ct Primary mediastinal large B-cell lymphoma Positive predictive value 

Notes

Compliance with ethical standards

Conflicts of interest

None.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Written consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Julien Lazarovici
    • 1
  • Marie Terroir
    • 2
  • Julia Arfi-Rouche
    • 3
  • Jean-Marie Michot
    • 4
  • Sacha Mussot
    • 5
  • Valentina Florea
    • 5
  • Maria-Rosa Ghigna
    • 6
  • Peggy Dartigues
    • 7
  • Cynthia Petrovanu
    • 1
  • Alina Danu
    • 1
  • Christophe Fermé
    • 1
  • Vincent Ribrag
    • 1
  • David Ghez
    • 1
  1. 1.Department of HematologyGustave Roussy and Université Paris SaclayVillejuifFrance
  2. 2.Department of Nuclear Medicine and Endocrine OncologyGustave Roussy and Université Paris SaclayVillejuifFrance
  3. 3.Department of RadiologyGustave Roussy and Université Paris SaclayVillejuifFrance
  4. 4.Department of Drug Development (DITEP)Gustave Roussy and Université Paris SaclayVillejuifFrance
  5. 5.Department of Thoracic SurgeryMarie Lannelongue HospitalLe Plessis RobinsonFrance
  6. 6.Department of PathologyMarie Lannelongue HospitalLe Plessis RobinsonFrance
  7. 7.Department of PathologyGustave Roussy and Université Paris SaclayVillejuifFrance

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