INTRODUCTION: Hodgkin lymphoma is an effectively treated malignancy, yet 20% of patients relapse or are refractory to front-line treatments with potentially fatal outcomes. Early detection of poor treatment responders is crucial for appropriate application of tailored treatment strategies. Tumour metabolic imaging of Hodgkin lymphoma using visual (qualitative) 18-fluorodeoxyglucose positron emission tomography (FDG-PET) is a gold standard for staging and final outcome assessment, but results gathered during the interim period are less accurate. Analysis of continuous metabolic-morphological data (quantitative) FDG-PET may enhance the robustness of interim disease monitoring, and help to improve treatment decision-making processes. The objective of this review is to compare diagnostic test accuracy of quantitative versus qualitative interim FDG-PET in the prognostication of patients with Hodgkin lymphoma. METHODS: The literature on this topic will be reviewed in a 3-step strategy that follows methods described by the Joanna Briggs Institute (JBI). First, MEDLINE and EMBASE databases will be searched. Second, listed databases for published literature (MEDLINE, Tripdatabase, Pedro, EMBASE, the Cochrane Central Register of Controlled Trials and WoS) and unpublished literature (Open Grey, Current Controlled Trials, MedNar, ClinicalTrials.gov, Cos Conference Papers Index and International Clinical Trials Registry Platform of the WHO) will be queried. Third, 2 independent reviewers will analyse titles, abstracts and full texts, and perform hand search of relevant studies, and then perform critical appraisal and data extraction from selected studies using the DATARI tool (JBI). If possible, a statistical meta-analysis will be performed on pooled sensitivity and specificity data gathered from the selected studies. Statistical heterogeneity will be assessed. Funnel plots, Begg's rank correlations and Egger's regression tests will be used to detect and/or correct publication bias. ETHICS AND DISSEMINATION: The results will be disseminated by publishing in a peer-reviewed journal. Ethical assessment will not be needed; only existing sources of literature will be searched. TRIAL REGISTRATION NUMBER: CRD42016027953.

Division of Hematology Oncology and Transplantation University of Minnesota Minneapolis Minnesota USA

Faculty of Medicine and Dentistry Department of Hemato Oncology Palacký University in Olomouc Olomouc Czech Republic

Faculty of Medicine and Dentistry Department of Hemato Oncology Palacký University in Olomouc Olomouc Czech Republic Faculty of Medicine and Dentistry The Czech Republic Centre for Evidence Based Health Care An Affiliated Centre of the Joanna Briggs Institute Palacký University in Olomouc Olomouc Czech Republic

Faculty of Medicine and Dentistry Department of Social Medicine and Public Health Palacký University in Olomouc Olomouc Czech Republic Faculty of Medicine and Dentistry The Czech Republic Centre for Evidence Based Health Care An Affiliated Centre of the Joanna Briggs Institute Palacký University in Olomouc Olomouc Czech Republic

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Shenoy P, Maggioncalda A, Malik N et al. . Incidence patterns and outcomes for Hodgkin lymphoma patients in the United States. Adv Hematology 2010;2011:725219 10.1155/2011/725219 PubMed DOI PMC

Dusek L, Pavlík T, Májek O et al. . Estimating cancer incidence, prevalence, and the number of cancer patients treated with antitumor therapy in 2015 and 2020—analysis of the Czech National Cancer Registry. Klin Onkol 2015;28:30–43. 10.14735/amko201530 PubMed DOI

Canellos G, Rosenberg S, Friedberg J et al. . Treatment of Hodgkin lymphoma: a 50-year perspective. J Clin Oncol 2014;32:163–8. 10.1200/JCO.2013.53.1194 PubMed DOI

Josting A, Rudolph C, Mapara M et al. . Cologne high-dose sequential chemotherapy in relapsed and refractory Hodgkin lymphoma: results of a large multicenter study of the German Hodgkin Lymphoma Study Group (GHSG). Ann Oncol 2005;16:116–23. 10.1093/annonc/mdi003 PubMed DOI

Moskowitz CH, Matasar MJ, Zelenetz AD et al. . Normalization of pre-ASCT, FDG-PET imaging with second-line, non-cross-resistant, chemotherapy programs improves event-free survival in patients with Hodgkin lymphoma. Blood 2012;119:1665–70. 10.1182/blood-2011-10-388058 PubMed DOI PMC

Barrington S, Mikhaeel G, Kostakoglu L et al. . Role of imaging in the staging and response assessment of lymphoma: consensus of the International Conference on Malignant Lymphomas Imaging Working Group. J Clin Oncol 2014;32:3048–58. 10.1200/JCO.2013.53.5229 PubMed DOI PMC

Meignan M, Barrington S, Itti E et al. . Report on the 4th International Workshop on Positron Emission Tomography in Lymphoma held in Menton, France, 3–5 October 2012. Leuk Lymphoma 2014;55:31–7. 10.3109/10428194.2013.802784 PubMed DOI

Carlier T, Bailly C. State-of-the-art and recent advances in quantification for therapeutic follow-up in oncology using PET. Front Med (Lausanne) 2015;2:18 10.3389/fmed.2015.00018 PubMed DOI PMC

Meignan M, Sasanelli M, Casasnovas R et al. . Metabolic tumour volumes measured at staging in lymphoma: methodological evaluation on phantom experiments and patients. Eur J Nucl Med Mol Imaging 2014;41:1113–22. 10.1007/s00259-014-2705-y PubMed DOI

Meignan M. VI. FDG-PET as a biomarker in lymphoma: from qualitative to quantitative analysis. Hematol Oncol 2015;33:38–41. 10.1002/hon.2214 PubMed DOI

Kobe C, Kuhnert G, Kahraman D et al. . Assessment of tumor size reduction improves outcome prediction of positron emission tomography/computed tomography after chemotherapy in advanced-stage Hodgkin lymphoma. J Clin Oncol 2014;32:1776–81. 10.1200/JCO.2013.53.2507 PubMed DOI

Kanoun S, Rossi C, Berriolo-Riedinger A et al. . Baseline metabolic tumour volume is an independent prognostic factor in Hodgkin lymphoma. Eur J Nucl Med Mol Imaging 2014;41:1735–43. 10.1007/s00259-014-2783-x PubMed DOI

Ceriani L, Martelli M, Zinzani PL et al. . Utility of baseline 18FDG-PET/CT functional parameters in defining prognosis of primary mediastinal (thymic) large B-cell lymphoma. Blood 2015;126:950–6. 10.1182/blood-2014-12-616474 PubMed DOI

Gallamini A, Hutchings M, Rigacci L et al. . Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin's lymphoma: a report from a joint Italian-Danish study. J Clin Oncol 2007;25:3746–52. 10.1200/JCO.2007.11.6525 PubMed DOI

Adams H, Nievelstein R, Kwee T. Prognostic value of interim FDG-PET in Hodgkin lymphoma: systematic review and meta-analysis. Br J Haematol 2015;170:356–66. 10.1111/bjh.13441 PubMed DOI

Sickinger MT, von Tresckow B, Kobe C et al. . Positron emission tomography-adapted therapy for first-line treatment in individuals with Hodgkin lymphoma. Cochrane Database Syst Rev 2015;1:CD010533 10.1002/14651858.CD010533.pub2 PubMed DOI PMC

Sickinger MT, von Tresckow B, Kobe C et al. . PET-adapted omission of radiotherapy in early stage Hodgkin lymphoma-a systematic review and meta-analysis. Crit Rev Oncol Hematol 2016;101:86–92. 10.1016/j.critrevonc.2016.03.005 PubMed DOI

Rossi C, Kanoun S, Berriolo-Riedinger A et al. . Interim 18F-FDG PET SUVmax reduction is superior to visual analysis in predicting outcome early in Hodgkin lymphoma patients. J Nucl Med 2014;55:569–73. 10.2967/jnumed.113.130609 PubMed DOI

Tseng D, Rachakonda L, Su Z et al. . Interim-treatment quantitative PET parameters predict progression and death among patients with Hodgkin's disease. Radiat Oncol 2012;7:5 10.1186/1748-717X-7-5 PubMed DOI PMC

Moher D, Shamseer L, Clarke M et al. . Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4:1 10.1186/2046-4053-4-1 PubMed DOI PMC

Campbell J, Klugar M, Ding S et al. . The systematic review of studies of diagnostic test accuracy. In: JBI, ed. Joanna Briggs Institute reviewers’ manual: 2015 edition/supplement. Adelaide, South Australia: The University of Adelaide, 2015:1–46.

Swerdlow S, Campo E, Harris N. WHO classification of tumours, volume 2; IARC WHO classification of tumours, No 2. Lyon, France: IARC Press, 2008.

Eichenauer DA, Engert A, Andre M et al. . Hodgkin's lymphoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2014;25(Suppl 3):iii70–5. 10.1093/annonc/mdu181 PubMed DOI

Hoppe RT, Advani RH, Ai WZ et al. . Hodgkin lymphoma, version 2.2012 featured updates to the NCCN guidelines. J Natl Compr Canc Netw 2012;10:589–97. PubMed

Campbell JM, Klugar M, Ding S et al. . Diagnostic test accuracy: methods for systematic review and meta-analysis. Int J Evid Based Healthc 2015;13:154–62. 10.1097/XEB.0000000000000061 PubMed DOI

Munn Z, Porritt K, Aromataris E et al. . Summary of findings tables for Joanna Briggs Institute systematic reviews. The University of Adelaide, South Australia: The Joanna Briggs Institute, 2014.