Metabolic Tumor Volume for Response Prediction in Advanced-Stage Hodgkin Lymphoma

Mettler, Jasmin; Müller, Horst; Voltin, Conrad-Amadeus; Baues, Christian; Klaeser, Bernd; Moccia, Alden; Borchmann, Peter; Engert, Andreas; Kuhnert, Georg; Drzezga, Alexander; Dietlein, Markus; Kobe, Carsten (2019). Metabolic Tumor Volume for Response Prediction in Advanced-Stage Hodgkin Lymphoma. Journal of nuclear medicine, 60(2), pp. 207-211. Society of Nuclear Medicine 10.2967/jnumed.118.210047

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Rationale: (18F)fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) for staging Hodgkin lymphoma may allow for accurate and reliable assessment of the metabolic tumour volume (MTV) as baseline risk factor. Our aim was to analyse the prognostic impact of MTV measurements, obtained by different means in advanced-stage Hodgkin lymphoma patients treated within the German Hodgkin Study Group HD18 trial. Methods: Within the German Hodgkin Study Group trial HD18, 310 patients underwent 18F-FDG PET/CT scanning for staging which was available to the central review panel for quantitative analysis. We calculated the MTV by four different thresholding methods and performed receiver operating characteristic (ROC) analysis to evaluate the potential for prediction of early response determined by PET after two cycles (PET-2) dose-escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP). Logistic regression was used to evaluate its prognostic value concerning progression-free survival (PFS) and overall survival (OS). Results: All different MTV calculations used predicted PET-2 response to a moderate and comparable degree (area under the curve = 0.62-0.63, P = 0.01-0.06). With none of the measuring methods did the ROC curves point to any unique cut-off values, but indicated a wide range of possible cut-offs. However, none of the MTV measurements was prognostic for PFS (Hazard ratio 1.2-1.5, P = 0.15-0.52) or OS (Hazard ratio 1.0-1.5, P = 0.95 - 0.27). Conclusion: Baseline MTV as determined by different means, is a predictive factor for early response to eBEACOPP after two cycles. However, value as a prognostic factor after highly effective PET-2 adapted treatment strategy could not be observed.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Clinic of Nuclear Medicine

UniBE Contributor:

Klaeser, Bernd


600 Technology > 610 Medicine & health




Society of Nuclear Medicine




Sabine Lanz

Date Deposited:

27 Jun 2019 11:01

Last Modified:

03 Jul 2020 16:06

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Hematology; Hodgkin lymphoma; Oncology: Lymphoma; PET/CT; metabolic tumour volume; progression-free survival; response prediction




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