Prognostic value of 18F-FDG PET/CT volumetric parameters in childhood, adolescent, and young adult Hodgkin lymphoma (CAYAHL): a systematic review from the international SEARCH group (Staging, Evaluation and Response Criteria Harmonization)
Bibliographic record
Abstract
Introduction In adults with classic Hodgkin lymphoma (cHL), PET volumetric parameters are valuable for risk stratification. This study was undertaken to explore the role of metabolic parameters in children, adolescents, and young adults with cHL. Methods This systematic review was performed according to the PRISMA method. Five databases were searched on 16 th October 2024: MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO), EBM Reviews (OVID) and the Web of Science Core Collection. Eligible studies were peer-reviewed manuscripts, written in English, published from database inception to the search date that included patients up to 21 years of age with a diagnosis of cHL and a 18 F-FDG PET/CT scan with calculation of MTV. Results The search strategy detected 3669 studies from which 1085 duplicates and 2584 studies were excluded following 2-person review of titles and abstracts. Full-text review of 81 papers identified 35 as eligible for inclusion. Fifteen of the papers (43%) evaluated a cohort exclusively<21 years of age and 20 papers (57%) considered children and adults, with a median of 69 (21-297) participants. All 8 studies that explored the association of baseline MTV and/or TLG (total lesion glycolysis) with known risk factors (ex. bulk, stage, clinical parameters used to define treatment group/level) identified a significant correlation. Twelve papers explored the association of baseline MTV and/or TLG with disease response on PET/CT according to Lugano criteria, of which 9 (75%) demonstrated a statistically significant correlation. Twenty papers explored the association of baseline PET parameters with clinical outcome (ex. overall survival, progression-free survival) and 15 (75%) demonstrated an independent statistically significant correlation. Of 6 studies that explored higher-order radiomic features, 4 (67%) found that they out-performed MTV and/or TLG. Thirty-three of 35 studies detailed the segmentation approach that was used to delineate disease, of which 11 used or recommended an absolute fixed threshold method. Conclusion Metabolic PET parameters are valuable for risk stratification; heterogeneity in results is related to differences in patient cohorts, treatment strategies, methods for disease segmentation, and parameter calculation. Recommendations regarding the necessary next steps to harmonize the approach and incorporate PET volumetric parameters into clinical practice for children, adolescents and young adults with cHL are discussed [ 1 ] [ 2 ] [ 3 ] [ 4 ] [ 5 ] [ 6 ] [ 7 ] [ 8 ] [ 9 ] [ 10 ]. Publication History Article published online: 02 December 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.026 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.009 | 0.008 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".