Aims and objectives
The goalof this study was to use the degree of X-ray attenuation [XRA] in Hounsfield units [HU] and lymph node/muscle attenuation ratio [LN/M] ratio in CT imaging routinely performed with the 18F-FDG-PET to distinguish HL affected supradiaphragmatic lymph nodes
Methods and materials
The study was based on PET-CT studies of 61 consecutive patients with classic HL treated according to the EuroNet-PHL-C1 Protocol.
Full analysis was performed in 50 patients with full set of PET-CT studies included: initial scans and scans performed afterreceived two OEPA chemotherapy blocks.The lymph nodes were evaluated according to the GPOH-HD-2002 study and Lugano criteria as unaffected by HL ("not-Involved"[NI-LN]) and affected ("Involved"[I-LN])
Results
A significant difference (p<0,001) in average XRA and LN/M values between NI-LN and I-LN both nodes in 18F-FDG-PET/CT performed before treatment (39,3±11,94 vs.
57,0±13,42HU; LN/M 0,70±0.22 vs.
1,01±0,28 respectively) and after two CHT blocks was found.
The optimal cut-off point for XRA (44,7HU;AUC=0,852) and LN/M (0,78;AUC=0,821) values distinguishing I-LN from NI-LN nodes was determined by ROC analysis.
Conclusion
The use of XRA(HU) and LN/M together with the existing standard in the evaluation of lymph nodes can improve the qualification of nodes as affected and free from HL.
Moreover,
these parameters may be useful in early response to CHT assessment.
References
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