Related Experiment Video
Updated: Aug 24, 2026
Multiplexed Fluorescent Immunohistochemical Staining, Imaging, and Analysis in Histological Samples of Lymphoma
Published on: January 9, 2019
The HD12 panel of the German Hodgkin Lymphoma Study Group (GHSG): a quality assurance program based on a
Hans Theodor Eich1, Susanne Staar, Axel Gossmann
1Department of Radiotherapy, University of Cologne, Germany. hans.eich@gmx.de
Insights
A central review panel enhanced quality assurance for computed tomography (CT) in Hodgkin disease trials. Helical CT provided superior imaging, and expert review identified discrepancies, improving patient care.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Hodgkin disease requires accurate staging and response assessment for optimal treatment.
- Multicenter trials necessitate robust quality control for diagnostic imaging.
- Previous studies highlight variability in computed tomography (CT) image quality.
Purpose of the Study:
- To evaluate the effectiveness of a central specialist radiologic review in Hodgkin disease trials.
- To assess the image quality of computed tomography (CT) scans within a multicenter study.
- To ensure appropriate radiotherapy delivery based on treatment response.
Main Methods:
- A multidisciplinary panel reviewed diagnostic imaging from the HD12 Hodgkin disease protocol.
- Image quality of helical CT was compared to conventional CT.
- Panel assessments were compared against study center documentation for staging accuracy.
Main Results:
- Helical CT demonstrated significantly better contrast enhancement and image quality than conventional CT (P < 0.001).
- CT scans from university hospitals were rated superior to those from other institutions (P < 0.001).
- The panel identified discrepancies in disease extent in 31% of CT scans, altering the stage in 5% of patients.
Conclusions:
- Centralized radiologic review significantly enhances quality assurance in multicenter Hodgkin disease trials.
- High-quality CT imaging is achievable in Hodgkin disease patients.
- Expert panel review can guide treatment decisions, such as recommending radiotherapy for residual disease.
Abstract:
The purpose of this report is to determine the value of a central specialist radiologic review and to determine the image quality of computed tomography (CT) in Hodgkin disease. The HD12 protocol is a multicenter prospective randomized trial of the GHSG for advanced stages of Hodgkin disease. The indication and effectiveness of additional radiotherapy (30 Gy), in the area of initial bulky disease and of residual disease, following intensive chemotherapy using the BEACOPP schema (bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisone), is to be investigated. A multidisciplinary panel of radiation oncologists, radiologists, and medical oncologists reviews, blinded to treatment arms, the diagnostic imaging with comparison to the documentation forms. For patients with poor response to chemotherapy, the panel recommends radiotherapy independent of the randomization. This procedure guarantees that patients with a poor response to chemotherapy receive additional radiotherapy. Furthermore, the panel evaluates the quality of CT examinations in this multicenter study. Since July 1999, a total of 2607 CT of 371 patients have been evaluated. Helical CT showed significantly higher contrast enhancement and imaging quality than conventional CT (P < 0.001). CT from university hospitals was assessed as superior to that from other institutions (P < 0.001). Compared with the written disease documentation by the study centers, the panel assessed different extensions of disease in 814 of 2607 CT (31%), resulting in a change of stage in 17 of 371 patients (5%). After chemotherapy, 167 of 371 patients (45%) showed residual disease (>1.5 cm), and for 53 of 371 patients (14%) the panel recommended additional radiotherapy independent of the randomization arm. Patients with Hodgkin disease receive high-quality CT imaging. A central independent multidisciplinary panel markedly improves quality assurance for these study patients.
