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      Comparing the accuracy of quantitative versus qualitative analyses of interim PET to prognosticate Hodgkin lymphoma: a systematic review protocol of diagnostic test accuracy

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          Abstract

          Introduction

          Hodgkin lymphoma is an effectively treated malignancy, yet 20% of patients relapse or are refractory to front-line treatments with potentially fatal outcomes. Early detection of poor treatment responders is crucial for appropriate application of tailored treatment strategies. Tumour metabolic imaging of Hodgkin lymphoma using visual (qualitative) 18-fluorodeoxyglucose positron emission tomography (FDG-PET) is a gold standard for staging and final outcome assessment, but results gathered during the interim period are less accurate. Analysis of continuous metabolic–morphological data (quantitative) FDG-PET may enhance the robustness of interim disease monitoring, and help to improve treatment decision-making processes. The objective of this review is to compare diagnostic test accuracy of quantitative versus qualitative interim FDG-PET in the prognostication of patients with Hodgkin lymphoma.

          Methods

          The literature on this topic will be reviewed in a 3-step strategy that follows methods described by the Joanna Briggs Institute (JBI). First, MEDLINE and EMBASE databases will be searched. Second, listed databases for published literature (MEDLINE, Tripdatabase, Pedro, EMBASE, the Cochrane Central Register of Controlled Trials and WoS) and unpublished literature (Open Grey, Current Controlled Trials, MedNar, ClinicalTrials.gov, Cos Conference Papers Index and International Clinical Trials Registry Platform of the WHO) will be queried. Third, 2 independent reviewers will analyse titles, abstracts and full texts, and perform hand search of relevant studies, and then perform critical appraisal and data extraction from selected studies using the DATARI tool (JBI). If possible, a statistical meta-analysis will be performed on pooled sensitivity and specificity data gathered from the selected studies. Statistical heterogeneity will be assessed. Funnel plots, Begg's rank correlations and Egger's regression tests will be used to detect and/or correct publication bias.

          Ethics and dissemination

          The results will be disseminated by publishing in a peer-reviewed journal. Ethical assessment will not be needed; only existing sources of literature will be searched.

          Trial registration number

          CRD42016027953.

          Related collections

          Most cited references16

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          Normalization of pre-ASCT, FDG-PET imaging with second-line, non-cross-resistant, chemotherapy programs improves event-free survival in patients with Hodgkin lymphoma.

          We previously reported that remission duration 80%, versus 28.6% for patients with a positive scan (P < .001). This prospective study provides evidence that the goal of SLT in patients with Hodgkin lymphoma should be a negative FDG-PET scan before HDT/ASCT.
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            Metabolic tumour volumes measured at staging in lymphoma: methodological evaluation on phantom experiments and patients.

            The presence of a bulky tumour at staging on CT is an independent prognostic factor in malignant lymphomas. However, its prognostic value is limited in diffuse disease. Total metabolic tumour volume (TMTV) determined on (18)F-FDG PET/CT could give a better evaluation of the total tumour burden and may help patient stratification. Different methods of TMTV measurement established in phantoms simulating lymphoma tumours were investigated and validated in 40 patients with Hodgkin lymphoma and diffuse large B-cell lymphoma.
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              Baseline metabolic tumour volume is an independent prognostic factor in Hodgkin lymphoma.

              The presence of a bulky tumour at staging in Hodgkin lymphoma (HL) is a predictor of a poor outcome. The total metabolic tumour volume at baseline (TMTV0) computed on PET may improve the evaluation of tumour burden. To explore the clinical usefulness of TMTV0, we compared the prognostic value of TMTV0, tumour bulk and interim PET response in a retrospective single-centre study.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2016
                5 August 2016
                : 6
                : 8
                : e011729
                Affiliations
                [1 ]Faculty of Medicine and Dentistry, Department of Hemato-Oncology, Palacký University in Olomouc , Olomouc, Czech Republic
                [2 ]Faculty of Medicine and Dentistry, Department of Social Medicine and Public Health, Palacký University in Olomouc , Olomouc, Czech Republic
                [3 ]Faculty of Medicine and Dentistry, The Czech Republic (Middle European) Centre for Evidence-Based Health Care: An Affiliated Centre of the Joanna Briggs Institute, Palacký University in Olomouc, Olomouc, Czech Republic
                [4 ]Division of Hematology, Oncology and Transplantation University of Minnesota , Minneapolis, Minnesota, USA
                Author notes
                [Correspondence to ] Dr Miloslav Klugar; miloslav.klugar@ 123456upol.cz
                Article
                bmjopen-2016-011729
                10.1136/bmjopen-2016-011729
                4986203
                27496236
                d2373e03-9682-4c27-82f2-ac52a85202fb
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 29 February 2016
                : 27 June 2016
                : 15 July 2016
                Categories
                Oncology
                Protocol
                1506
                1717
                1694
                1689

                Medicine
                hodgkin lymphoma,pet,tlg,suv
                Medicine
                hodgkin lymphoma, pet, tlg, suv

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