Prognostic Utility of Quantitative PET Parameters on Baseline and Interim FDG-PET Scans in Hodgkin Lymphoma

Natalia Kovaleva; Shin Hnin Wai; Niamh Waters; Sze-Ting Lee; Andrew Carey; Hui Z Lim; Oliver Piercey; Andrew M Scott; Eliza A Hawkes; Geoffrey Chong

doi:10.1016/j.clml.2025.07.005

Prognostic Utility of Quantitative PET Parameters on Baseline and Interim FDG-PET Scans in Hodgkin Lymphoma

Clin Lymphoma Myeloma Leuk. 2025 Oct;25(10):e865-e873.e3. doi: 10.1016/j.clml.2025.07.005. Epub 2025 Jul 12.

Authors

Affiliations

¹ Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Victoria, Australia.
² Cancer services, Austin Health, Melbourne, Victoria, Australia.
³ Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Victoria, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia.
⁴ Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
⁵ Cancer services, Eastern Health, Melbourne, Victoria, Australia.
⁶ Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia; Cancer services, Eastern Health, Melbourne, Victoria, Australia.
⁷ Cancer services, Austin Health, Melbourne, Victoria, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia; School of Cancer Medicine, La Trobe University, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
⁸ Cancer services, Austin Health, Melbourne, Victoria, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia; Faculty of Medicine, University of Melbourne, Melbourne, Victoria, Australia. Electronic address: Geoff.Chong@austin.org.au.

PMID: 40783348
DOI: 10.1016/j.clml.2025.07.005

Abstract

Background: In classical Hodgkin lymphoma (cHL), interim positron emission tomography (iPET) using Deauville Score (DS) guides therapy. Quantitative PET parameters, including changes in maximum standard uptake value [ΔSUVmax], total metabolic tumor volume [ΔTMTV], total lesion glycolysis [ΔTLG], may enhance the predictive value of iPET.

Methods: This retrospective study analysed 98 cHL patients from 2008 to 2022, assessing quantitative PET parameters at baseline (PET0), after 2 or 3 chemotherapy cycles (iPET), and associations with survival outcomes.

Results: Advanced-stage disease was present in 45% of patients. At PET0, no parameters were significantly associated with progression-free survival (PFS). At iPET, the only quantitative parameter independently associated with inferior PFS was ΔSUVmax <72% (HR 5.1, 95% CI 1.7-15.5, P = .004). DS positivity was also independently associated with inferior PFS (HR 2.92, 95% CI 1.07-8.01, P = 037). iPET parameters of ΔTLG <99%, and ΔTMTV <99% achieved univariate but not independent statistical significance.

Conclusion: Larger prospective studies are needed to validate these findings and evaluate quantitative PET parameters in cHL patient risk stratification.

Keywords: Deauville Score; Hodgkin's lymphoma; Metabolic tumor volume; Positron emission tomography; SUVmax.

MeSH terms

Adolescent
Adult
Aged
Female
Fluorodeoxyglucose F18*
Hodgkin Disease* / diagnosis
Hodgkin Disease* / diagnostic imaging
Hodgkin Disease* / drug therapy
Hodgkin Disease* / mortality
Hodgkin Disease* / pathology
Humans
Male
Middle Aged
Positron-Emission Tomography* / methods
Prognosis
Retrospective Studies
Young Adult

Substances

Fluorodeoxyglucose F18