Prognostic value of baseline metabolic tumor volume (<scp>MTV</scp>) for forecasting chemotherapy outcome in early‐stage unfavorable Hodgkin lymphoma: Data from the phase <scp>III HD17</scp> trial
Lutz van Heek, Jasmin Weindler, Claudia Gorniak, Helen Kaul, Horst Müller, Jasmin Mettler, Christian Baues, Michael Fuchs, Peter Borchmann, Justin Ferdinandus, Markus Dietlein, Conrad‐Amadeus Voltin, Carsten Kobe, Katrin Sabine Roth
Abstract
Abstract Objectives The prognostic relevance of metabolic tumor volume (MTV) having recently been demonstrated in patients with early‐stage favorable and advanced‐stage Hodgkin lymphoma. The current study aimed to assess the potential prognostic value of 18 F‐fluorodeoxyglucose (FDG) positron emission tomography (PET) in early‐stage unfavorable Hodgkin lymphoma patients treated within the German Hodgkin Study Group HD17 trial. Methods 18 F‐FDG PET/CT images were available for MTV analysis in 154 cases. We used three different threshold methods (SUV 2.5 , SUV 4.0 , and SUV 41% ) to calculate MTV. Receiver‐operating‐characteristic analysis was performed to describe the value of these parameters in predicting an adequate therapy response. Therapy response was evaluated as PET negativity after 2 cycles of eBEACOPP followed by 2 cycles of ABVD. Results All three threshold methods analyzed for MTV showed a positive correlation with the PET response after chemotherapy. Areas under the curve (AUC) were 0.70 (95% CI 0.53–0.87) and 0.65 (0.50–0.80) using the fixed thresholds of SUV 4.0 and SUV 2.5 , respectively, for MTV‐ calculation. The calculation of MTV using a relative threshold of SUV 41% showed an AUC of 0.63 (0.47–0.79). Conclusions MTV does have predictive value after chemotherapy in early‐stage unfavorable Hodgkin lymphoma, particularly when the fixed threshold of SUV 4.0 is used for MTV calculation. Trial registration : ClinicalTrials.gov NCT01356680.