Inter-Reader Reliability of Early FDG-PET/CT Response Assessment Using the Deauville Scale after 2 Cycles of Intensive Chemotherapy (OEPA) in Hodgkin's Lymphoma
Language English Country United States Media electronic-ecollection
Document type Journal Article, Multicenter Study, Randomized Controlled Trial
PubMed
26963909
PubMed Central
PMC4786307
DOI
10.1371/journal.pone.0149072
PII: PONE-D-15-35241
Knihovny.cz E-resources
- MeSH
- Child MeSH
- Doxorubicin administration & dosage MeSH
- Etoposide administration & dosage MeSH
- Glucose-6-Phosphate administration & dosage analogs & derivatives MeSH
- Hodgkin Disease diagnostic imaging drug therapy MeSH
- Humans MeSH
- Adolescent MeSH
- Tomography, X-Ray Computed * MeSH
- Positron-Emission Tomography * MeSH
- Prednisone administration & dosage MeSH
- Child, Preschool MeSH
- Antineoplastic Combined Chemotherapy Protocols administration & dosage MeSH
- Vincristine administration & dosage MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
- Names of Substances
- 2-fluoro-2-deoxyglucose-6-phosphate MeSH Browser
- Doxorubicin MeSH
- Etoposide MeSH
- Glucose-6-Phosphate MeSH
- Prednisone MeSH
- Vincristine MeSH
PURPOSE: The five point Deauville (D) scale is widely used to assess interim PET metabolic response to chemotherapy in Hodgkin lymphoma (HL) patients. An International Validation Study reported good concordance among reviewers in ABVD treated advanced stage HL patients for the binary discrimination between score D1,2,3 and score D4,5. Inter-reader reliability of the whole scale is not well characterised. METHODS: Five international expert readers scored 100 interim PET/CT scans from paediatric HL patients. Scans were acquired in 51 European hospitals after two courses of OEPA chemotherapy (according to the EuroNet-PHL-C1 study). Images were interpreted in direct comparison with staging PET/CTs. RESULTS: The probability that two random readers concord on the five point D score of a random case is only 42% (global kappa = 0.24). Aggregating to a three point scale D1,2 vs. D3 vs. D4,5 improves concordance to 60% (kappa = 0.34). Concordance if one of two readers assigns a given score is 70% for score D1,2 only 36% for score D3 and 64% for D4,5. Concordance for the binary decisions D1,2 vs. D3,4,5 is 67% and 86% for D1,2,3 vs D4,5 (kappa = 0.36 resp. 0.56). If one reader assigns D1,2,3 concordance probability is 92%, but only 64% if D4,5 is called. Discrepancies occur mainly in mediastinum, neck and skeleton. CONCLUSION: Inter-reader reliability of the five point D-scale is poor in this interobserver analysis of paediatric patients who underwent OEPA. Inter-reader variability is maximal in cases assigned to D2 or D3. The binary distinction D1,2,3 versus D4,5 is the most reliable criterion for clinical decision making.
Clinic of Nuclear Medicine National Hospital for Active Treatment in Oncology Sofia Bulgaria
Department of Nuclear Medicine Blackrock Clinic Dublin Ireland
Department of Nuclear Medicine University Hospital of Cologne Cologne Germany
Department of Nuclear Medicine University of Leipzig Leipzig Germany
Department of Paediatric Oncology University Children's Hospital Zurich Switzerland
Department of Pediatric Oncology University of Halle Halle Saale Germany
Dept of PET and Molecular Imaging Nicolaus Copernicus University Collegium MedicumBydgoszcz Poland
Institute for Medical Informatics Statistics and Epidemiology University of Leipzig Leipzig Germany
Karolinska University Hospital Astrid Lindgrens Childrens Hospital Stockholm Sweden
Pediatric Oncology Unit Hospitales Universitarios Virgen Macarena y Virgen del Rocio Sevilla Spain
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