Prognostic value of baseline metabolic tumor volume (MTV) for forecasting chemotherapy outcome in early‐stage unfavorable Hodgkin lymphoma: Data from the phase III HD17 trial

Abstract

AbstractObjectivesThe 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 18F‐fluorodeoxyglucose (FDG) positron emission tomography (PET) in early‐stage unfavorable Hodgkin lymphoma patients treated within the German Hodgkin Study Group HD17 trial.Methods18F‐FDG PET/CT images were available for MTV analysis in 154 cases. We used three different threshold methods (SUV2.5, SUV4.0, and SUV41%) 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.ResultsAll 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 SUV4.0 and SUV2.5, respectively, for MTV‐ calculation. The calculation of MTV using a relative threshold of SUV41% showed an AUC of 0.63 (0.47–0.79).ConclusionsMTV does have predictive value after chemotherapy in early‐stage unfavorable Hodgkin lymphoma, particularly when the fixed threshold of SUV4.0 is used for MTV calculation.Trial registration: ClinicalTrials.gov NCT01356680.