Head and neck PET/CT therapy response interpretation criteria (Hopkins criteria) - external validation study.

• Type of Material: Article
• Authors: Ayse Tuba Kendi, Mayo Clinic; David Brandon, Emory University; Jeffrey Switchenko, Emory University; Jeffery Trad Wadsworth, Emory University; Mark El-Deiry, Emory University; Nabil Saba, Emory University; David Schuster, Emory University; Rathan M Subramaniam, Johns Hopkins University
• Language: English
• Date: 2017
• Publisher: e-Century Publishing
• Publication Version: Final Published Version
• Copyright Statement: AJNMMI © 2017
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://www.ajnmmi.us/ajnmmi_V7N4.html
• Title of Journal or Parent Work: American Journal of Nuclear Medicine and Molecular Imaging
• ISSN: 2160-8407
• Volume: 7
• Issue: 4
• Start Page: 174
• End Page: 180
• Grant/Funding Information: Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of Winship Cancer Institute of Emory University and NIH/NCI under award number P30CA138292.
• Keywords: PET/CT; Hopkins criteria; Head and neck carcinoma
• Research Categories: Health Sciences, Oncology; Health Sciences, Radiology

Abstract

Qualitative assessment of PET/CT results in post therapy is very important to provide a reproducible and systemic reporting. A recently introduced response criteria, known as the Hopkins criteria showed promising results. Our aim is to externally validate the Hopkins interpretation system to assess therapy response in head and neck squamous cell cancer (HNSCC). The study included 69 biopsy proven HNSCC patients who underwent post therapy PET/CT between 5-24 weeks after completion of therapy. PET/CT images were interpreted by one nuclear medicine physician and one nuclear radiologist, independently. The studies were scored according to the Hopkins criteria for right neck, left neck, primary tumor site, and overall assessment. Scores 1, 2, 3 were considered as negative and scores 4 and 5 were considered as positive for tumors. Inter-reader variability was assessed using percent agreement and Kappa statistics. Progression-free survival (PFS) was estimated using the Kaplan-Meier method and analyzed using Cox proportional hazards regression. Of the 69 patients, 59 (85.5%) were males, with a mean age of 62.8 years. The percent agreement between readers for overall, right neck, left neck, and primary tumor site were 91.3%, 97.6%, 97.6%, 91.3% respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the overall therapy assessment were 66.7%, 87.3%, 33%, 96.5% respectively. Cox univariate regression analysis showed positive primary tumor site scores and overall scores were associated with a higher risk of progression (p<0.05). External validation of Hopkins criteria showed excellent inter-reader agreement and prediction of PFS in HNSCC patients.