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Inter-reader reliability of early FDG-PET/CT response assessment using the Deauville Scale after 2 cycles of intensive chemotherapy (OEPA) in Hodgkin’s Lymphoma

Purpose: The five point Deauville (D) scale is widely used to assess interim PET metabolic response to chemotherapy in Hodgkin lymphoma (HL) patients. An International Validation Study reported good concordance among reviewers in ABVD treated advanced stage HL patients for the binary discrimination between score D1,2,3 and score D4,5. Inter-reader reliability of the whole scale is not well characterised. Methods: Five international expert readers scored 100 interim PET/CT scans from paediatric HL patients. Scans were acquired in 51 European hospitals after two courses of OEPA chemotherapy
(according to the EuroNet-PHL-C1 study). Images were interpreted in direct comparison with staging PET/CTs. Results: The probability that two random readers concord on the five point D score of a random case
is only 42% (global kappa = 0.24). Aggregating to a three point scale D1,2 vs. D3 vs. D4,5 improves concordance to 60% (kappa = 0.34). Concordance if one of two readers assigns a given score is 70% for score D1,2 only 36% for score D3 and 64% for D4,5. Concordance
for the binary decisions D1,2 vs. D3,4,5 is 67% and 86% for D1,2,3 vs D4,5 (kappa = 0.36 resp. 0.56). If one reader assigns D1,2,3 concordance probability is 92%, but only 64% if D4,5 is called. Discrepancies occur mainly in mediastinum, neck and skeleton. Conclusion: Inter-reader reliability of the five point D-scale is poor in this interobserver analysis of paediatric patients who underwent OEPA. Inter-reader variability is maximal in cases assigned to D2 or D3. The binary distinction D1,2,3 versus D4,5 is the most reliable criterion for clinical decision making.

Identiferoai:union.ndltd.org:DRESDEN/oai:qucosa.de:bsz:15-qucosa-204087
Date08 June 2016
CreatorsKluge, Regine, Chavdarova, Lidia, Hoffmann, Martha, Kobe, Carsten, Malkowski, Bogdan, Montravers, Françoise, Kurch, Lars, Georgi, Thomas, Dietlein, Markus, Hamish Wallace, W., Karlen, Jonas, Fernández-Teijeiro, Ana, Cepelova, Michaela, Wilson, Lorrain, Bergstraesser, Eva, Sabri, Osama, Mauz-Körholz, Christine, Körholz, Dieter, Hasenclever, Dirk
ContributorsUniversität Leipzig, Medizinische Fakultät, National Hospital for Active Treatment in Oncology, Clinic of Nuclear Medicine, Medizinische Universität Wien, Klinische Abteilung für Nuklearmedizin, Universität Köln, Klinik und Poliklinik für Nuklearmedizin, Nicolaus Copernicus University, Collegium Medicum, Public Libray of Science,
PublisherUniversitätsbibliothek Leipzig
Source SetsHochschulschriftenserver (HSSS) der SLUB Dresden
LanguageEnglish
Detected LanguageEnglish
Typedoc-type:article
Formatapplication/pdf
SourcePLoS ONE 11(3): e0149072 doi:10.1371/journal.pone.0149072

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