Publications by authors named "Kurch L"
Importance: The current standard-of-care salvage therapy in relapsed/refractory classic Hodgkin lymphoma (cHL) includes consolidation high-dose chemotherapy (HDCT)/autologous stem cell transplant (aSCT).
Objective: To investigate whether presalvage risk factors and fludeoxyglucose-18 (FDG) positron emission tomography (PET) response to reinduction chemotherapy can guide escalation or de-escalation between HDCT/aSCT or transplant-free consolidation with radiotherapy to minimize toxic effects while maintaining high cure rates.
Design, Setting, And Participants: EuroNet-PHL-R1 was a nonrandomized clinical trial that enrolled patients younger than 18 years with first relapsed/refractory cHL across 68 sites in 13 countries in Europe between January 2007 and January 2013.
Article Synopsis
- The study aimed to validate a deep learning model for predicting treatment outcomes in diffuse large B-cell lymphoma patients across 5 clinical trials, comparing it to the international prognostic index (IPI) and radiomic models.
- The deep learning model, trained on PET/CT scans, demonstrated a higher predictive performance (AUC of 0.66) than IPI (AUC of 0.60) and performed well across all trials.
- While the deep learning and clinical PET models showed similar performance (AUC of 0.69), the PET model achieved the highest AUC (0.71), although the deep learning model provided outcomes without requiring tumor delineation.
Article Synopsis
- Hodgkin lymphoma involving the central nervous system (CNS) is very rare, with a reported incidence of 0.9% in a study of nearly 5,000 pediatric patients.
- Most cases had single lesions in areas like the thoracic and lumbar spine, which originated from nearby soft tissue or bone rather than directly in the CNS parenchyma.
- After two cycles of chemotherapy, a significant majority of lesions showed complete metabolic response, and while some lesions were treated with radiation, relapses were minimal, highlighting the importance of surrounding tissues in the management of CNS involvement.
Article Synopsis
- Hypodense volumes (HDV) in mediastinal masses were identified in 29.7% of Hodgkin lymphoma patients analyzed from a study involving 1178 staging CT scans.
- These HDVs were predominantly found in larger tumor volumes and exhibited various patterns, including single lesions in 69.4% of cases and well delineated lesions in 70.1% of cases.
- Patients with HDV displayed more severe symptoms and had a lower 5-year progression-free survival rate (79.6% for HDV > 40 ml) compared to those with lower HDV levels, indicating a potential connection between HDV presence and poorer prognosis in Hodgkin lymphoma.
Lymphoma represent the third most common malignant disease in childhood and adolescence. They are divided into pediatric Hodgkin lymphoma (P-HL) and pediatric non-Hodgkin lymphoma (P-NHL). In P-HL, excellent cure rates are achieved through combined modality treatment using chemotherapy and radiotherapy.
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- New lung lesions were identified in 9.2% of pediatric Hodgkin lymphoma patients after two chemotherapy cycles, indicating that these may not be related to cancer progression.
- The study utilized interim CT scans to differentiate between true lung metastases and benign lung lesions, using guidelines from the Fleischner glossary for classification.
- Most newly detected pulmonary nodules were small (under 10 mm) and often regressed by the time of later evaluations, suggesting they were likely not harmful manifestations associated with the original lymphoma.
Activated brown fat (aBAT) is known to affect the evaluation of F-FDG PET scans, especially in young patients. The aim of this study was to determine factors influencing the occurrence of aBAT, and to investigate the effectiveness of the two preventive measures, warming and beta-blocker (propranolol) administration. Five-hundred-twenty-eight F-FDG-PET scans of 241 EuroNet-PHL-C2 trial patients from 41 nuclear medicine departments in Germany and Czech Republic were screened for aBAT.
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- Scientists are studying different types of imaging to see how well they can find and assess neuroblastoma in kids, especially comparing a method called mIBG with new PET scans.!
- They looked at 10 studies involving 181 patients and found that the PET scans could detect more tumors than the mIBG method in many cases.!
- Although PET scans seem to work better, doctors are still figuring out if this will really change how they treat patients in the future.!
Background: The aim of this work is to provide the currently missing evidence that may allow an update of the Paediatric Dosage Card provided by the European Association of Nuclear Medicine (EANM) for conventional PET/CT systems.
Methods: In a total of 2082 consecutive [F]FDG-PET scans performed within the EuroNet-PHL-C2 trial, the administered [F]FDG activity was compared to the activity recommended by the EANM Paediatric Dosage Card. None of these scans had been rejected beforehand by the reference nuclear medicine panel of the trial because of poor image quality.
Convolutional neural networks (CNNs) may improve response prediction in diffuse large B-cell lymphoma (DLBCL). The aim of this study was to investigate the feasibility of a CNN using maximum intensity projection (MIP) images from F-fluorodeoxyglucose (F-FDG) positron emission tomography (PET) baseline scans to predict the probability of time-to-progression (TTP) within 2 years and compare it with the International Prognostic Index (IPI), i.e.
View Article and Find Full Text PDFBackground: Post-transplant lymphoproliferative disorders (PTLD) are heterogeneous lymphoid disorders ranging from indolent polyclonal proliferations to aggressive lymphomas that can arise after solid organ transplantation (SOT) and allogeneic hematopoietic transplantation (allo-HSCT).
Methods: In this multi-center retrospective study, we compare patient characteristics, therapies, and outcomes of PTLD after allo-HSCT and SOT. Twenty-five patients (15 after allo-HSCT and 10 after SOT) were identified who developed PTLD between 2008 and 2022.
Background: Rebound thymic hyperplasia (RTH) is a common phenomenon caused by stress factors such as chemotherapy (CTX) or radiotherapy, with an incidence between 44% and 67.7% in pediatric lymphoma. Misinterpretation of RTH and thymic lymphoma relapse (LR) may lead to unnecessary diagnostic procedures including invasive biopsies or treatment intensification.
View Article and Find Full Text PDFThe objective of this study is to externally validate the clinical positron emission tomography (PET) model developed in the HOVON-84 trial and to compare the model performance of our clinical PET model using the international prognostic index (IPI). In total, 1195 patients with diffuse large B-cell lymphoma (DLBCL) were included in the study. Data of 887 patients from 6 studies were used as external validation data sets.
View Article and Find Full Text PDFIntroduction: Interim PET (iPET) assessment is important for response adaptation in Hodgkin lymphoma (HL). The current standard for iPET assessment is the Deauville score (DS). The aim of our study was to evaluate the causes of interobserver variability in assigning the DS for iPET in HL patients and to make suggestions for improvement.
View Article and Find Full Text PDFResponse-adapted omission of radiotherapy in children and adolescents with early-stage classical Hodgkin lymphoma and an adequate response to vincristine, etoposide, prednisone, and doxorubicin (EuroNet-PHL-C1): a titration study.
Lancet Oncol
March 2023
Article Synopsis
- The study investigates the feasibility of omitting radiotherapy for children and adolescents with early-stage classical Hodgkin lymphoma who respond adequately to OEPA chemotherapy, aiming to improve survival and quality of life.
- Conducted across 186 hospitals in 16 European countries, the EuroNet-PHL-C1 trial enrolled over 2100 patients, focusing on maintaining a 5-year event-free survival rate of 90% without the use of radiotherapy.
- The trial results, based on a median follow-up time of about 63 months, include data from 714 patients in the experimental treatment group, assessing the effectiveness and outcomes of the chemotherapy regimen.
Purpose: Chimeric antigen receptor (CAR)-T cells are a viable treatment option for patients with relapsed or refractory (r/r) aggressive B-cell lymphomas. The prognosis of patients who relapse after CAR-T cell treatment is dismal and factors predicting outcomes need to be identified. Our aim was to assess the value of FDG-PET/CT in terms of predicting patient outcomes.
View Article and Find Full Text PDFF-FDG PET/MRI might be the diagnostic method of choice for Hodgkin lymphoma patients, as it combines significant metabolic information from PET with excellent soft-tissue contrast from MRI and avoids radiation exposure from CT. However, a major issue is longer examination times than for PET/CT, especially for younger children needing anesthesia. Thus, a targeted selection of suitable whole-body MRI sequences is important to optimize the PET/MRI workflow.
View Article and Find Full Text PDFPositron emission tomography (PET) has been widely used in paediatric oncology. 2-Deoxy-2-[F]fluoro-D-glucose ([F]FDG) is the most commonly used radiopharmaceutical for PET imaging. For oncological brain imaging, different amino acid PET radiopharmaceuticals have been introduced in the last years.
View Article and Find Full Text PDFIntroduction: The automatic classification of lymphoma lesions in PET is a main topic of ongoing research. An automatic algorithm would enable the swift evaluation of PET parameters, like texture and heterogeneity markers, concerning their prognostic value for patients outcome in large datasets. Moreover, the determination of the metabolic tumor volume would be facilitated.
View Article and Find Full Text PDFA 28-year-old female patient with active and difficult-to-treat systemic lupus erythematosus (SLE) was diagnosed with liver-dominant diffused large B-cell lymphoma. Repeated response F-FDG-PET studies showed persistently high, and, despite intensified immunochemotherapy, further increasing metabolic activity of one of the hepatic lymphoma residuals, whereas all other initial lymphoma manifestations had achieved complete metabolic remission. As biopsy of the F-FDG-PET-positive liver residual turned out to be inconclusive, complete resection was performed.
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- * Conducted at 186 hospitals across 16 European countries, this randomized controlled trial compares two and four cycles of a chemotherapy protocol (COPP) aimed at reducing long-term side effects, particularly gonadotoxicity.
- * The research excludes early-stage patients and includes a detailed regimen of medications, including vincristine, etoposide, prednisone, doxorubicin, cyclophosphamide, and procarbazine, to evaluate their impact on survival and quality of life.
Background: Interim [F]fluoro-deoxyglucose-positron emission tomography predicts outcome in peripheral T-cell lymphoma (PTCL). We compared two quantitative evaluation methods.
Methods: Interim scans from 43 patients with anaplastic lymphoma kinase-negative PTCL from the 'Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas' trial were re-analyzed by qPET (relating residual lymphoma-related uptake to liver uptake) and ∆SUV (relating interim scan to baseline scan).
Aim: In 2015, the revised International Pediatric Non-Hodgkin Lymphoma Staging System was published. It mentions [F]-FDG-PET/MRI as the latest method to perform whole-body imaging. However, supporting data are pending.
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