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Does PET Reconstruction Method Affect Deauville Score in Lymphoma Patients?
Blandine Enilorac1, Charline Lasnon2, Cathy Nganoa1
1Nuclear Medicine Department, Caen University Hospital, Caen, France.
Summary
The choice of positron emission tomography (PET) reconstruction method does not impact the Deauville score or the ability to stratify diffuse large B-cell lymphoma patients. Point-spread function (PSF) modeling is suitable for clinical use and multicenter trials.
Area of Science:
- Nuclear Medicine
- Radiology
- Oncology
Background:
- The Deauville score (DS) is crucial for evaluating 18F-FDG PET images in lymphoma patients.
- Point-spread function (PSF) modeling in PET reconstruction can increase standardized uptake values (SUVs) in tumors, potentially affecting DS.
- Investigating the impact of different reconstruction algorithms on DS and patient stratification is essential.
Purpose of the Study:
- To determine if the choice of PET reconstruction algorithm affects the Deauville score in diffuse large B-cell lymphoma (DLBCL).
- To assess whether any discordance in DS impacts 18F-FDG PET's capability to stratify DLBCL patients.
- To evaluate the clinical applicability of PSF reconstruction in routine practice and multicenter studies.
Main Methods:
- 126 DLBCL patients underwent interim PET (i-PET) and end-of-treatment PET (EoT-PET) scans.
- PET data were reconstructed using unfiltered point-spread function (PSF) and PSF with an EANM Research Ltd. (EARL) harmonization filter (PSFEARL).
- Deauville scores were calculated by comparing SUVmax in lesions to reference organs (liver/aorta); patient stratification was analyzed.
Main Results:
- Major discordance in DS classification between PSF and PSFEARL was low (5.0% for i-PET, 3.2% for EoT-PET).
- High concordance (Cohen's κ = 0.82 for i-PET, 0.89 for EoT-PET) was observed between the two reconstruction methods.
- Kaplan-Meier analysis demonstrated statistically significant differences in progression-free and overall survival based on response, irrespective of the reconstruction method used.
Conclusions:
- The choice of PET reconstruction algorithm (PSF vs. PSFEARL) does not influence the Deauville score or the risk stratification of DLBCL patients.
- PSF reconstruction is deemed suitable for routine clinical processes and multicenter trials in DLBCL management.
- Further validation is recommended for escalation and deescalation treatment strategies based on early i-PET findings.
