Comparison of the International Harmonization Project, London and Gallamini criteria in the interpretation of 18F-FDG PET/CT examinations after first-line treatment in Hodgkin’s lymphoma

Abstract

Fluorine 18-fluorodeoxyglucose (F-FDG) PET/computed tomography (CT) has been reported to have a wide-ranging positive predictive value (PPV) in the literary data on Hodgkin's lymphoma after first-line therapy. This study was carried out to compare the usefulness of the International Harmonization Project, London and Gallamini criteria in the interpretation of F-FDG PET/CT examinations for this indication. Data from 66 patients with a median follow-up care of 54 months were evaluated. The initial stage had been I-II in the case of 45 patients and III-IV in the case of 21 patients. The analysis based on the International Harmonization Project criteria resulted in a negative predictive value (NPV) of 98.0% and a PPV of 62.5%. Using mediastinal blood pool and liver activity as the thresholds for the London criteria, the NPV and PPV were 98.0 and 62.5% and 98.1 and 71.4%, respectively. Considering only those lesions with F-FDG uptake that was markedly higher than liver uptake as positive, the NPV and PPV were 94.7 and 88.9%, respectively. The analysis based on the Gallamini criteria resulted in an NPV of 96.2% and a PPV of 69.2%. Using the London criteria with liver activity as the threshold seems to be a good approach for the interpretation of post-treatment F-FDG PET/CT studies because of its high accuracy and simplicity.