Page 60 - 18F-FDG PET as biomarker in aggressive lymphoma; technical and clinical validation

Chapter 3
Fig. 2 Forest plot of univariate hazard ratios for interim PET scans in diffuse large B-cell lymphoma.
This plot shows the univariate hazard ratios (black squares, size based on study size), and 95% CI’s (horizontal lines) of the individual studies sorted by publication year for PFS/EFS of the interim PET positive and negative patients. The estimated pooled effect estimation is shown with a diamond. For each study a 2x2 contingency table at 2 years follow-up is shown
In Fig.3 the ROC curves of the different visual criteria are shown.The studies that were classified as “custom”, did not have comparable scan positivity definitions and therefore no summary curve for this group was presented. We found no statistically significant differences between the curves for Deauville and IHP. There was a trend (P = 0.0503) towards a higher accuracy for studies with DLBCL 80–99% versus studies with 100% DLBCL patients.
Discussion
This systematic review and meta-analysis included 20 studies comprising a total of 2,411 DLBCL patients who underwent interim 18F-FDG PET. Eighteen studies were eligible for the HR and 19 for the HSROC meta-analyses. We found a pooled estimated HR of 3.13 (95% CI 2.52–3.89) for interim PET in the prediction of PFS or EFS. The prediction interval ranged from 1.68 to 5.83, suggesting that a new study investigating the prognostic value of interim PET on PFS or EFS will find a HR in this range with 95% confidence. These results
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