ARRS 2022 Abstracts

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E2070. Utility of Adding Delta SUV Max on Interim 18F-FDG PET/CT in Patients with Lymphoma and Deauville Score of 4
Authors
  1. Pokhraj Suthar; Rush University Medical Center
  2. Mohammed Alagha; Rush University Medical Center
  3. Sumeet Virmani; Rush University Medical Center
Background
Interim PET-CT (i-PET) is a widely utilized noninvasive imaging modality to assess response to various treatment regimens in patients with Hodgkin's and certain non-Hodgkin's lymphoma. Response assessment on i-PET, usually performed after 2 cycles of chemotherapy, is based on Deauville scoring, where any residual FDG uptake greater than that of the liver is considered an unfavorable response. In our experience at a tertiary care teaching institution, a small subset of patients will have a significant response on i-PET with a Deauville score of 4 based on the current reporting guidelines. This subset of patients usually require discussion with the treating physician for treatment optimization, especially if there is more than 50% change in SUVmax from the baseline scan [delta SUVmax]). We present a case-based pictorial review highlighting the importance of reporting delta SUVmax in patients with Deauville score of 4 on i-PET.

Educational Goals / Teaching Points
We present 10 interesting cases with subsequent follow-up to completion chemotherapy that highlight the importance of reporting delta SUVmax in the subset of patients with Deauville score of 4 on i-PET.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This case-based pictorial review focuses on highlighting the importance of reporting delta SUVmax of the residual lesion in a subset of patients with Deauville score of 4 on i-PET. Providing this additional information helps the clinician optimize treatment in specific clinical situations. The optimal delta SUVmax depends on the timeline of the i-PET (i.e., performed after second, third, or fourth cycle of chemotherapy) and remains to be further characterized.

Conclusion
Adding delta SUVmax in the subset of patients with a Deauville score of 4 on i-PET impacts patient management and helps the clinician optimize treatment.