Standardizing Interpretation Criteria for Early Response Evaluation with 18f-FDG PET/CT in Paediatric Lymphoma

Closed for proposals

Project Type

Coordinated Research Project

Project Code

E12017

CRP

1981

Approved Date

4 June 2013

Status

4 - Closed

Start Date

4 July 2013

Expected End Date

4 July 2018

Completed Date

8 November 2018

Participating Countries

Australia
Bangladesh
Brazil
Canada
Germany
India
Israel
Pakistan
South Africa
United Kingdom of Great Britain and Northern Ireland
Uruguay

Description

Paediatric lymphoma is the third most common childhood malignancy and comprises 15% of childhood cancer and this condition is not only observed in the Paediatric practice in developed countires but also seen in developing countries as well.There are no validated standardized criteria for evaluation of treatment response by PET/CT in Paediatric lymphoma. Nevertheless, management decisions are based on PET/CT findings during primary diagnosis and treatment response evaluations. The current study contracts issued. RCM report.aims to document the variability in interpretation of 18F-FDG PET/CT performed for assessing response to therapy in Paediatric lymphoma, evaluating the prognostic power of different interpretation methodologies and suggesting a preferred set of interpretation criteria which may be used to standardized PET review in clinical practice and trials. This proposed CRP will provide Paediatric Nuclear medicine practitioners in developing  Member States the opportunity to enagage in this international coordinated research with developed Member States to both to recruit patients in the Paediatric lymphoma population for PET/CT evaluation in response to therapy as well as improve diagnostic accuracy and consistency in interpreting the scans through preferred set of interpretation criteria which may be used towards standardized PET review in clinical practice and trials. 

Objectives

Improved clinical management of Paediatric patients with lymphomas in Member States through the use of PET/CT Technology through appropriate use of standardized evaluation criteria for interpretation of Paediatric PET/CT examinations with particular reference to studies performed for early response evaluation for Paediatric Lymphomas (interim PET/CT).

Specific objectives

To determine the inter-observer variability of Paediatric PET/CT study readings between groups of participating institutions.

To establish standardized evaluation criteria for interpretation of Paediatric PET/CT examinations with particular reference to studies performed for early response evaluation for HD (interim PET/CT).

To establish standardized evaluation criteria for interpretation of Paediatric PET/CT examinations with particular reference to studies performed for early response evaluation for NHL (interim PET/CT).

Impact

Validation of standardized interpretation criteria for early response evaluation with 18F-FDG PET/CT in paediatric lymphoma established. This will improve the clinical management of paediatric patients with lymphoma.

The role of FDG PET/CT in the management of lymphoma, a malignancy encountered in all age groups, is well established for several indications along the disease course. This is based mainly on adult or mixed age groups populations, with only limited data available exclusively for paediatric lymphoma patients. Many of the assumptions in performance and interpretation of 18-FDG PET/CT images in these patients are derived from the knowledge and experience of adult imaging, while different considerations may sometimes be required when children are involved. Evaluation of response to therapy is important to guide further therapy and prognosis.

The results of this Project may contribute to establishment of standardized evaluation criteria for interpretation of paediatric PET/CT examinations with particular reference to studies performed for early response evaluation for paediatric patients with HD and NHL (interim PET/CT).

The utility of PET/CT as an efficient health technology tool further validated.

Relevance

This CRP emphasized the importance of PET/CT in the management of Paediatric Lymphomas. Paediatric lymphoma is the third most common childhood malignancy and comprises 15% of childhood cancer. Although a highly curable disease, a relapse rate of 5-20% is found in paediatric lymphoma patients, most within the first 3 years post therapy, indicating a worse prognosis for these patients.

Final analyses showed that Lugano criteria positive 18F-FDG PET/CT scan at interim evaluation is an independent predictor of decreased overall survival in paediatric lymphoma patients. LC+ studies are able to independently predict decreased event free survival in patients with HL but not patients with NHL.

Limited whole body (eyes to thighs ) instead of true whole body (vertex to toes) PET/CT scans should be performed for both staging and interim PET/CT evaluation in children with lymphoma.

This CRP involved the use of nuclear imaging technologies such as F-18 FDG in PET/CT Imaging for evaluating and standardizing the interpretation criteria for response to therapy in Paediatric lymphomas.

CRP Publications

Type

Conference Paper

Year

October 2018

Description

“Validation of Standardized Interpretation Criteria for Early Response Evaluation with 18FDG-PET/CT in Paediatric Lymphoma- A Report on an IAEA Multicenter Prospective Study”

Country/Organization

2018 European Congress of Nuclear Medicine

Type

Conference Paper , has been ranked within the best communications (oral/e-Poster) of all submitted papers and is therefore considered for a possible inclusion in the Highlights Lecture

Year

October 2018

Description

“True Whole-Body Versus Standard 18F-FDG PET/CT Acquisition For Staging Paediatric Lymphoma”

Country/Organization

2018 European Congress of Nuclear Medicine

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