The Deauville 5-Point Scale Improves the Prognostic Value of Interim FDG PET/CT in Extranodal Natural Killer/T-Cell Lymphoma

Clin Nucl Med. 2015 Oct;40(10):767-73. doi: 10.1097/RLU.0000000000000892.

Abstract

Purpose: The prognostic value of FDG PET/CT in extranodal natural killer/T-cell lymphoma (ENKTL) is still controversial. Furthermore, the utility of the Deauville 5-point scale (DS) in ENKTL is uncertain. Therefore, we designed a prospective study to examine the prognostic value of 3 methods of PET/CT analysis (International Harmonization Project [IHP] criteria, DS, and SUV-based assessment).

Patients and methods: Sixty patients with newly diagnosed untreated ENKTL were enrolled. PET/CT evaluation was performed before initial treatment (pretreatment) and midtreatment (interim). Interim PET/CT response was determined based on IHP criteria, DS, and change in FDG uptake (ΔSUVmax). International Harmonization Project criteria, DS, and ΔSUVmax were then examined for the ability to predict progression-free survival (PFS) and overall survival (OS).

Results: Over a median follow-up of 23.5 months, interim PET/CT based on DS and ΔSUVmax were significant predictors of PFS and OS. After multivariate analysis, DS was an independent predictor of PFS (P < 0.001) and OS (P < 0.001). ΔSUVmax was an independent predictor of OS (P = 0.013) but not PFS (P = 0.054) and with a lower accuracy and positive predictive value than DS.

Conclusions: Interim PET/CT analysis with DS predicts unfavorable treatment outcomes of ENKTL patients, whereas interim PET/CT analysis based on IHP criteria and SUV-based assessment have limited prognostic value.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Lymphoma, T-Cell / diagnostic imaging*
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Positron-Emission Tomography*
  • Radiopharmaceuticals
  • Tomography, X-Ray Computed*

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18