Publication: Inter-Reader Reliability of Early FDG-PET/CT Response Assessment Using the Deauville Scale after 2 Cycles of Intensive Chemotherapy (OEPA) in Hodgkin's Lymphoma.
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Identifiers
Date
2016-03-10
Authors
Kluge, Regine
Chavdarova, Lidia
Hoffmann, Martha
Kobe, Carsten
Malkowski, Bogdan
Montravers, Françoise
Kurch, Lars
Georgi, Thomas
Dietlein, Markus
Wallace, W Hamish
Advisors
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Publisher
Public Library of Science
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Abstract
Purpose
The five point Deauville (D) scale is widely used to assess interim PET metabolic response to chemotherapy in Hodgkin lymphoma (HL) patients. An International Validation Study reported good concordance among reviewers in ABVD treated advanced stage HL patients for the binary discrimination between score D1,2,3 and score D4,5. Inter-reader reliability of the whole scale is not well characterised.
METHODS
Five international expert readers scored 100 interim PET/CT scans from paediatric HL patients. Scans were acquired in 51 European hospitals after two courses of OEPA chemotherapy (according to the EuroNet-PHL-C1 study). Images were interpreted in direct comparison with staging PET/CTs.
RESULTS
The probability that two random readers concord on the five point D score of a random case is only 42% (global kappa = 0.24). Aggregating to a three point scale D1,2 vs. D3 vs. D4,5 improves concordance to 60% (kappa = 0.34). Concordance if one of two readers assigns a given score is 70% for score D1,2 only 36% for score D3 and 64% for D4,5. Concordance for the binary decisions D1,2 vs. D3,4,5 is 67% and 86% for D1,2,3 vs D4,5 (kappa = 0.36 resp. 0.56). If one reader assigns D1,2,3 concordance probability is 92%, but only 64% if D4,5 is called. Discrepancies occur mainly in mediastinum, neck and skeleton.
CONCLUSION
Inter-reader reliability of the five point D-scale is poor in this interobserver analysis of paediatric patients who underwent OEPA. Inter-reader variability is maximal in cases assigned to D2 or D3. The binary distinction D1,2,3 versus D4,5 is the most reliable criterion for clinical decision making.
Description
Journal Article;
MeSH Terms
Medical Subject Headings::Named Groups::Persons::Age Groups::Child
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Histologic Type::Lymphoma::Hodgkin Disease
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Publication Type::Study Characteristics::Multicenter Study
Medical Subject Headings::Anatomy::Musculoskeletal System
Medical Subject Headings::Publication Type::Study Characteristics::Clinical Trial::Randomized Controlled Trial
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Specialty Uses of Chemicals::Laboratory Chemicals::Indicators and Reagents::Radiopharmaceuticals
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Reproducibility of Results
Medical Subject Headings::Anatomy::Musculoskeletal System::Skeleton
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Tomography::Tomography, X-Ray::Tomography, X-Ray Computed
Medical Subject Headings::Persons::Persons::Age Groups::Adolescent
Medical Subject Headings::Diseases::Neoplasms::Neoplasms by Histologic Type::Lymphoma::Hodgkin Disease
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Publication Type::Study Characteristics::Multicenter Study
Medical Subject Headings::Anatomy::Musculoskeletal System
Medical Subject Headings::Publication Type::Study Characteristics::Clinical Trial::Randomized Controlled Trial
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Specialty Uses of Chemicals::Laboratory Chemicals::Indicators and Reagents::Radiopharmaceuticals
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Research Design::Reproducibility of Results
Medical Subject Headings::Anatomy::Musculoskeletal System::Skeleton
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Tomography::Tomography, X-Ray::Tomography, X-Ray Computed
Medical Subject Headings::Persons::Persons::Age Groups::Adolescent
DeCS Terms
CIE Terms
Keywords
Ensayo clínico controlado aleatorio, Enfermedad de Hodgkin, Sistema musculoesquelético, Estudio multicéntrico, Brown adipose tissue, Chemotherapy, Positron emission tomography, Lymphomas, Pediatrics, Hodgkin lymphoma, Lymph nodes, Thymus
Citation
Kluge R, Chavdarova L, Hoffmann M, Kobe C, Malkowski B, Montravers F, et al. Inter-Reader Reliability of Early FDG-PET/CT Response Assessment Using the Deauville Scale after 2 Cycles of Intensive Chemotherapy (OEPA) in Hodgkin's Lymphoma. PLoS ONE. 2016; 11(3):e0149072