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1670 SUVR (SUVmax Lymphoma/SUVmax Liver) Vs Deauville Score for Predicting Relapse in Hodgkin Lymphoma

Program: Oral and Poster Abstracts
Session: 624. Hodgkin Lymphomas: Clinical and Epidemiological: Poster I
Hematology Disease Topics & Pathways:
Research, Hodgkin lymphoma, Epidemiology, Lymphomas, Clinical Research, Diseases, Real-world evidence, Lymphoid Malignancies, Technology and Procedures, Imaging
Saturday, December 7, 2024, 5:30 PM-7:30 PM

Angelo Rizzolo, MD1, Noah Ben-Ezra, MD2*, Richard Liu, MD2*, Matthew Salaciak, M.Sc.3*, Peter Maliha, MD4*, Stephan Probst, MD2* and Nathalie A. Johnson, MD, PhD,5

1Division of Hematology, Jewish General Hospital, Montreal, QC, Canada
2Division of Nuclear Medicine, Jewish General Hospital, Montreal, QC, Canada
3Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
4Nuclear Medicine, Centre Hospitalier de l’Université de Montréal Centre de Recherche, Université de Montréal, Montreal, QC, Canada
5Jewish General Hospital, Montreal, QC, Canada

Background

The Deauville score (DS) assessed by fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is the current standard method for evaluating treatment response in patients with Hodgkin lymphoma (HL). However, DS is a qualitative and somewhat subjective evaluation. Recent evidence supports the use of the standardized uptake value ratio (SUVR) as a more quantitative and objective assessment of treatment response.

Objective

To compare the diagnostic performance of DS and SUVR at the EOT FDG PET/CT in predicting PFS in patients with HL.

Methods

We included patients with classical HL treated with curative intent between 2000 and 2019 who had EOT PET/CT scans. Each EOT scan was re-scored according to DS and SUVR. SUVR was defined as lesional SUVmax divided by liver SUVmax. Receiver operator curve (ROC) analysis determined the optimal SUVR cut-off value using Youden's index. We computed sensitivity, specificity, positive, and negative predictive values (PPV & NPV) for DS (positive ≥ 4) and SUVR (positive ≥ 1.13). Kaplan-Meier curves and Cox-regression analysis evaluated the PFS predictive ability of the two response-assessment modalities. Informed consent was obtained from all patients.

Results

157 patients had available data at the EOT timepoint. Median age was 31, and 30% had limited favorable disease at diagnosis, defined as Stage I-IIA, non-bulky. Most patients received frontline ABVD chemotherapy (4-6 cycles) and 16 patients (10%) received radiation therapy. There were 35 PFS events, including 5 deaths. The optimal SUVR cut-off at EOT was 1.13. Median PFS among patients with positive DS or SUVR was 8.1 and 8.2 months, respectively. Diagnostic parameters for DS and SUVR were similar (PPV: 77% and 78%, respectively). Both DS and SUVR predicted PFS (HR 2.46 [95% CI 0.29-20.66] and HR 9.06 [95% CI 1.08-75.87], respectively).

Conclusion

Both SUVR with a positivity threshold of 1.13 and DS are predictive of PFS at EOT and have similar diagnostic parameters in patients with HL. However, SUVR offers a more objective assessment of treatment response.

Disclosures: No relevant conflicts of interest to declare.

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