Early evaluation of tumor response to 90Y-ibritumomab radioimmunotherapy in relapsed/refractory B cell non-Hodgkin lymphoma: what is the optimal timing for FDG-PET/CT?
Purpose: To determine the earliest optimal timing for assessment of early response following radioimmunotherapy in non-Hodgkin lymphoma patients using FDG-PET/CT.Methods: FDG-PET/CT was performed prior to treatment (PET1), at 2 (PET2) weeks, and at 6 (PET3) weeks after 90Y-ibritumomab radioimmunothe...
| Published in: | European Radiology Vol. 29; no. 7; pp. 3935 - 3945 |
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| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
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Springer Nature
Jul2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136842427&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136842427 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Jul2019 vid: 29 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 136842427 136842427 NLM30899979 10.1007/s00330-019-06134-7 NLM30899979 136842427 ppf: 3935 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Early evaluation of tumor response to 90Y-ibritumomab radioimmunotherapy in relapsed/refractory B cell non-Hodgkin lymphoma: what is the optimal timing for FDG-PET/CT? aug: au: Kitajima, Kazuhiro Okada, Masaya Kashiwagi, Toru Yoshihara, Kyoko Tokugawa, Tazuko Sawada, Akihiro Yoshihara, Satoshi Fujimori, Yoshihiro Yamakado, Koichiro affil: Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, 663-8501, Nishinomiya, Hyogo, Japan sug: subj: Lymphoma, B-Cell Drug Therapy Radioimmunotherapy Methods Radionuclide Imaging Methods Antibodies, Monoclonal Therapeutic Use Prospective Studies Aged, 80 and Over Disease Progression B Lymphocytes Aged Adult Middle Age Male Neoplasm Recurrence, Local Drug Therapy Female Lymphoma, B-Cell Fludeoxyglucose F 18 Administration and Dosage Scales Aged, 80 & over Aged: 65+ years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Purpose: To determine the earliest optimal timing for assessment of early response following radioimmunotherapy in non-Hodgkin lymphoma patients using FDG-PET/CT.Methods: FDG-PET/CT was performed prior to treatment (PET1), at 2 (PET2) weeks, and at 6 (PET3) weeks after 90Y-ibritumomab radioimmunotherapy in 55 patients. Response was evaluated based on the Deauville 5-point scale and Lugano criteria as well as semiquantitative analysis and compared with progression-free survival (PFS).Results: PET 2 showed complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease (PMD) in 33, 13, 6, and 3 patients, respectively, while PET 3 in 41, 8, 3, and 3 patients, respectively. Mean SUVmax of 168 target lesions decreased over time (PET1, 2, 3; 5.58 ± 2.58, 1.87 ± 1.78, 1.75 ± 2.25, respectively). Progression or recurrence after a median of 12.6 months (range 2.6-72.0 months) was seen in 44 patients. Patients with CMR or metabolic response (CMR + PMR) on PET2 showed significantly longer PFS as compared to those who did not (p = 0.00028 and p = 0.029, respectively). A similar significant difference was observed based on PET3 (p = 0.00013 and p = 0.017, respectively). The same trend was observed when analyzing only the subgroup of patients with follicular lymphoma (N = 43/55) (p < 0.0001).Conclusion: Use of FDG-PET/CT findings with Lugano criteria for assessing early response to radioimmunotherapy after 6 weeks allowed for accurate evaluation and prognostic stratification, though scanning after 2 weeks was too soon to precisely evaluate response.Key Points: • The optimal timing of FDG-PET/CT to obtain a suitable tool for assessment of response after 90 Y-ibritumomab radioimmunotherapy of lymphoma has not yet been defined. • Assessment after 6 weeks by FDG-PET/CT using the Lugano criteria accurately evaluates treatment response and prognosis. • FDG-PET/CT performed 2 weeks after radioimmunotherapy is too early as it significantly misses objective responses. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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