Role of Baseline Metabolic Tumor Volume in Early-Stage Favorable Hodgkin Lymphoma – Data from the Prospective, Multicenter Phase III HD16 Trial

Ziel/Aim ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) plays an important role in the staging and response assessment of lymphoma patients. Our aim was to explore the prognostic relevance of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with early stage Hodgkin lymphoma treated within the German Hodgkin Study Group HD16 trial.

Methodik/Methods ¹⁸F-FDG PET/CT images were available for MTV and TLG analysis in 107 patients from the HD16 trial. We calculated MTV and TLG each using three different threshold methods and performed receiver-operating-characteristic analysis to describe the prognostic impact for an adequate therapy response with PET negativity after 2 cycles of chemotherapy.

Ergebnisse/Results All the methods analyzed for MTV and TLG calculation showed a certain correlation with the PET response after 2 cycles chemotherapy. The largest area under the curve (AUC) showed the fixed threshold of SUV_4.0 for MTV (AUC 0.69 [95% CI 0.55–0.83]) and for TLG(AUC 0.69 [0.55–0.82]). Other thresholds considered were SUV₁₄₀ (AUC for MTV 0.66 [0.53–0.80], AUC for TLG 0.67 [0.54–0.81]) and SUV_41% (AUC for MTV 0.61 [0.45–0.76], AUC for TLG 0.64 [0.49–0.80]). ROC curves do not suggest any specific cutoffs. Overall, TLG was not superior to MTV in its predictive capacity.

Schlussfolgerungen/Conclusions MTV and TLG show a moderate effect on outcome after two cycles ABVD in early stage Hodgkin lymphoma, particularly when using the fixed threshold of SUV_4.0 [1] [2] [3] [4] [5].

• Literatur/References

• 1 Fuchs M, Goergen H, Kobe C. et al. Positron Emission Tomography-Guided Treatment in Early-Stage Favorable Hodgkin Lymphoma: Final Results of the International, Radomized Phase II HD16 Trial by the German Hodgkin Study Group. J Clin Oncol 2019; 37 (31) 2835-45
• 2 Kanoun S, Rossi C, Berriolo-Riedinger A. et al. Baseline metabolic tumour volume is an independent prognostic factor in Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 2014; 41: 1735-43
• 3 Cottereau AS, Versari A, Loft A. et al. Prognostic value of baseline metabolic tumor volume in early-stage Hodgkin lymphoma in the standard arm of the H10 trial. Blood 2018; 131: 1456-63
• 4 Mettler J, Müller H, Voltin CA. et al. Metabolic Tumor Volume for Response Prediction in Advance-Stage Hodgkin Lymphoma. J Nucl Med 2019; 60: 207-11
• 5 Tutino F, Puccini G, Linguanti F. et al. Baseline metabolic tumor volume calculation using different SUV thresholding methods in Hodgkin Lymphoma patients: interobserver argreement and reproducibility across software platforms. Nuc Med Com 2021; 42 (03) 284-91

Publication History

Article published online:
14 April 2022