Does Volumetric Metabolic PET/CT Parameters have impact in Prognosis in Pediatric Lymphoma patients.

Document Type : Review Article


Professor of Nuclear Medicine, Faculty of Medicine, Cairo University.


Aim of work: we aimed to evaluate the role of metabolic parameters extracted from volumetric PET images in predicting early metabolic therapy response, and to investigate the prognostic and predictive value of initial volumetric based PET/CT in pediatric Hodgkin lymphoma on therapy outcome and disease-free survival rate. HD has shown improvement in survival, which shifted the current interest towards early identification and stratifications of the patients who are at risk of treatment failure (poor response to first-line therapy or initial response with subsequent relapse). This will reduce treatment-related Sequelae, which include secondary malignancies and cardiovascular events. Unfortunately, current risk-stratification criteria fail to identify these children. F-18 FDG PET/CT is established as a powerful tool for both initial staging and early response assessment in HL. However, there is a paucity of studies that identify the role of baseline F-18 FDG PET/CT for risk stratification and prediction of OS and PFS. Some studies have assessed the value of various baseline metabolic parameters (namely whole-body metabolic tumor volume, [WB MTV] and total lesion glycolysis [TLG]) for risk stratification and prediction of OS and PFS. However, data are limited (especially in paediatric patients) and somewhat conflicting; therefore, we aimed to further investigate these promising parameters.
Conclusions: Interim PET/CT in pediatric Hodgkin lymphoma using Deauville score remains the best indicator for prediction of therapy response, different patients’ characteristics could have correlation with clinical outcome and response to therapy using SUVmax.