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J Nucl Med. 2012; 53 (Supplement 1):506
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Oncology: Clinical Diagnosis

Hodgkin Disease and Myeloma

Analysis of the Deauville criteria for the assessment of interim PET in advanced stage Hodgkin lymphoma patients enrolled in the IVS study part II: Reliability of score and concordance between reviewers

Alberto Biggi1, Sally Barrington5, Martin Hutchings4, Michele Gregianin6, Michel Meignan2, Lale Kostakoglu3, Stephane Chauvie1 and Andrea Gallamini1

1 S. Croce and Carle Hospital, Cuneo, Italy 2 CHU H. Mondor, Paris, France 3 Mount Sinai Medical Center, New York, NY 4 Rigshospitalet Copenhagen, Copenhagen, Denmark 5 St.Thomas Hospital, London, United Kingdom 6 Oncology Institute of Veneto, Padova, Italy

Abstract No. 506

Objectives: The Deauville criteria FDG uptake is scored based on intensity. The choice of threshold to define a ‘positive’ scan depends on whether a high sensitivity or specificity is desired. The aim of this study was to test if the level of agreement between reporters is also influenced by threshold.

Methods: An international validation study (IVS) was performed to measure PFS in HL according to interim PET-CT. Paired scans were reported by 6 independent reviewers and uptake scored as: (1) none (2) ≤ mediastinum (3) ≤ liver (4) moderately increased uptake > liver (5) markedly increased uptake > liver. For IVS, score 4 or 5 was regarded as positive, score 1,2,3 as ‘negative’. Levels of agreement between reporters were measured for IVS (5 categories), then for 3 categories using score 1 or 2 (complete metabolic response) vs score 3 (equivocal) vs score 4 or 5 (disease) and for individual scores of 1 vs 2 vs 3 vs 4 vs 5. Agreement was calculated using Krippendorf’s alpha coefficient.

Results: 261 paired scans were evaluated. There was concordance between the majority of reporters (> 4 agreed on the identical score) in 97% of cases for IVS, in 87% using CMR vs equivocal vs disease categories and in 65% using individual scores of 1-5. The level of agreement was α = 0.758 (IVS) α = 0.542 (3 categories) α = 0.352 (scores 1-5).

Conclusions: Agreement between reporters was fair using scores 1-5 and moderate or good using fewer but more clinically relevant categories. Levels of agreement are better using the liver rather than the mediastinum as a reference region


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Level of agreement with different threshold for interim PET positivity

 




This Article
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Right arrow Similar articles in this journal
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Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Biggi, A.
Right arrow Articles by Gallamini, A.
PubMed
Right arrow Articles by Biggi, A.
Right arrow Articles by Gallamini, A.