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Abstract：
In the EuroNet Pediatric Hodgkin Lymphoma (EuroNet-PHL) trials, decision on Waldeyer\'s ring (WR) involvement is usually based on clinical assessment, that is, physical examination and/or nasopharyngoscopy. However, clinical assessment only evaluates mucosal surface and is prone to interobserver variability. Modern cross-sectional imaging technology may provide valuable information beyond mucosal surface, which may lead to a more accurate WR staging.
The EuroNet-PHL-C1 trial recruited 2102 patients, of which 1752 underwent central review including reference reading of their cross-sectional imaging data. In 14 of 1752 patients, WR was considered involved according to clinical assessment. In these 14 patients, the WR was re-assessed by applying an imaging-based algorithm considering information from 18 F-fluorodeoxyglucose positron emission tomography, contrast-enhanced computed tomography, and/or magnetic resonance imaging. For verification purposes, the imaging-based algorithm was applied to 100 consecutive patients whose WR was inconspicuous on clinical assessment.
The imaging-based algorithm confirmed WR involvement only in four of the 14 patients. Of the remaining 10 patients, four had retropharyngeal lymph node involvement and six an inconspicuous WR. Applying the imaging-based algorithm to 100 consecutive patients with physiological appearance of their WR on clinical assessment, absence of WR involvement could be confirmed in 99. However, suspicion of WR involvement was raised in one patient.
The imaging-based algorithm was feasible and easily applicable at initial staging of young patients with Hodgkin lymphoma. It increased the accuracy of WR staging, which may contribute to a more individualized treatment in the future.
The EuroNet-PHL-C1 trial recruited 2102 patients, of which 1752 underwent central review including reference reading of their cross-sectional imaging data. In 14 of 1752 patients, WR was considered involved according to clinical assessment. In these 14 patients, the WR was re-assessed by applying an imaging-based algorithm considering information from 18 F-fluorodeoxyglucose positron emission tomography, contrast-enhanced computed tomography, and/or magnetic resonance imaging. For verification purposes, the imaging-based algorithm was applied to 100 consecutive patients whose WR was inconspicuous on clinical assessment.
The imaging-based algorithm confirmed WR involvement only in four of the 14 patients. Of the remaining 10 patients, four had retropharyngeal lymph node involvement and six an inconspicuous WR. Applying the imaging-based algorithm to 100 consecutive patients with physiological appearance of their WR on clinical assessment, absence of WR involvement could be confirmed in 99. However, suspicion of WR involvement was raised in one patient.
The imaging-based algorithm was feasible and easily applicable at initial staging of young patients with Hodgkin lymphoma. It increased the accuracy of WR staging, which may contribute to a more individualized treatment in the future.
摘要：
在EuroNet小儿霍奇金淋巴瘤（EuroNet-PHL）试验中，关于Waldeyer戒指(WR)参与的决定通常基于临床评估，也就是说,体格检查和/或鼻咽镜检查。然而,临床评估仅评估粘膜表面，并且容易出现观察者间的变异性。现代横断面成像技术可以提供粘膜表面以外的有价值的信息，这可能会导致更准确的WR分期。
EuroNet-PHL-C1试验招募了2102名患者，其中1752人接受了中央检查,包括横断面影像数据的参考阅读.1752名患者中有14名，根据临床评估，WR被认为涉及。在这14名患者中，通过应用基于成像的算法重新评估WR，考虑来自18F-氟代脱氧葡萄糖正电子发射断层扫描的信息，对比增强计算机断层扫描，和/或磁共振成像。出于验证目的，基于成像的算法应用于临床评估中WR不明显的100例连续患者.
基于成像的算法仅在14例患者中有4例证实WR受累。剩下的10个病人,4例咽后淋巴结受累，6例WR不明显。将基于成像的算法应用于临床评估中具有WR生理外观的100例连续患者，在99例中可以确认没有WR参与。然而,一名患者怀疑WR参与。
基于成像的算法在年轻霍奇金淋巴瘤患者的初始分期中是可行且易于应用的。它提高了WR分期的准确性，这可能有助于未来更个性化的治疗。
EuroNet-PHL-C1试验招募了2102名患者，其中1752人接受了中央检查,包括横断面影像数据的参考阅读.1752名患者中有14名，根据临床评估，WR被认为涉及。在这14名患者中，通过应用基于成像的算法重新评估WR，考虑来自18F-氟代脱氧葡萄糖正电子发射断层扫描的信息，对比增强计算机断层扫描，和/或磁共振成像。出于验证目的，基于成像的算法应用于临床评估中WR不明显的100例连续患者.
基于成像的算法仅在14例患者中有4例证实WR受累。剩下的10个病人,4例咽后淋巴结受累，6例WR不明显。将基于成像的算法应用于临床评估中具有WR生理外观的100例连续患者，在99例中可以确认没有WR参与。然而,一名患者怀疑WR参与。
基于成像的算法在年轻霍奇金淋巴瘤患者的初始分期中是可行且易于应用的。它提高了WR分期的准确性，这可能有助于未来更个性化的治疗。
