engleski

Negative predictive value of F-18-FDG coincidence PET in patients with Hodgkin's disease and a residual mass after therapy: a retrospective diagnostic test study

Aim: To asses the negative predictive value (NPV) of FDG-PET performed with triple-head coincidence gamma camera after first-line therapy or salvage therapy in patients with Hodgkin’ s disease (HD) compared by long-term follow-up as a reference standard. Design and Setting: This retrospective diagnostic test study was done in University Hospital Centre Zagreb between June 2001 and February 2008. Participants: The charts of 131 consecutive patients with Hodgkin’ s disease were reviewed. Seventy-three consecutive PET-negative patients (median age 28 years ; range 12-80 years) with primary or recurrent biopsy confirmed lymphoma after first-line therapy or salvage therapy were followed-up at least 12 months (median 23 months ; range 12-69 months). All already performed 18F-FDG PET scans (using hybrid PET camera with triple head coincidence imaging capability within a few months after completion of therapy) were again visually interpreted by two board-certified nuclear medicine physicians who were blinded to any clinical or CT data. Main outcome measure: The negative predictive value of FDG-PET performed with triple-head coincidence gamma camera (Index test) was compared with long-term follow-up as a reference standard. Results: Out of 131 patients 73 turned-out to be PET-negative. Of those 73 PET-negative patients, 61 have been scanned after first-line chemotherapy/radiotherapy, and only 3 of them relapsed in a follow-up (negative predictive value 0.95). Twelve patients with resistant disease have been scanned after repeated therapy, and 4 of them relapsed in a follow-up period (negative predictive value 0.66). Conclusions: This methodology with triple-head coincidence gamma camera has high negative predictive value. A negative PET scan can reassure patients and their doctors that disease is not active.

Hodgkin’ s disease; fluorine-18-fluorodeoxyglucose; FDG; PET; coincidence; therapy monitoring; prognosis; follow-up; negative predictive value

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