title: SUVmax reduction improves early prognosis value of interim positron emission tomography scans in diffuse large B-cell lymphoma.
abstract: The prognostic value of interim positron emission tomography (PET) interpreted according to visual criteria is a matter of debate in diffuse large B-cell lymphoma (DLBCL). Maximal standardized uptake value reduction (ΔSUVmax) may better predict outcome. To compare the prognostic value of both methods, we analyzed PET done at baseline (PET0) and after 2 (PET2) and 4 (PET4) cycles in 85 patients with high-risk DLBCL enrolled on a prospective multicenter trial. All images were centrally reviewed and interpreted visually according to the International Harmonization Project criteria and by computing ΔSUVmax between PET0 and PET2 (ΔSUVmaxPET0-2) or PET4 (ΔSUVmaxPET0-4). Optimal cutoff to predict progression or death was 66% for ΔSUVmaxPET0-2 and 70% for ΔSUVmaxPET0-4. Outcomes did not differ significantly whether PET2 and PET4 were visually positive or negative. Inversely, ΔSUVmaxPET0-2 analysis (> 66% vs ≤ 66%) identified patients with significantly different 2-year progression-free survival (77% vs 57%; P = .0282) and overall survival (93% vs 60%; P < .0001). ΔSUVmaxPET0-4 analysis (> 70% vs ≤ 70%) seemed even more predictive for 2-year progression-free survival (83 vs 40%; P < .0001) and overall survival (94% vs 50%; P < .0001). ΔSUVmax analysis of sequential interim PET is feasible for high-risk DLBCL and better predicts outcome than visual analysis. The trial was registered at http://clinicaltrials.gov as NCT00498043.
authors.affiliation: Hopital Le Bocage, Dijon, France. casasnovas@chu-dijon.fr
authors.forename: René-Olivier
authors.initials: RO
authors.lastname: Casasnovas
authors.forename: Michel
authors.initials: M
authors.lastname: Meignan
authors.forename: Alina
authors.initials: A
authors.lastname: Berriolo-Riedinger
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bardet
authors.forename: Anne
authors.initials: A
authors.lastname: Julian
authors.forename: Catherine
authors.initials: C
authors.lastname: Thieblemont
authors.forename: Pierre
authors.initials: P
authors.lastname: Vera
authors.forename: Serge
authors.initials: S
authors.lastname: Bologna
authors.forename: Josette
authors.initials: J
authors.lastname: Brière
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Jais
authors.forename: Corinne
authors.initials: C
authors.lastname: Haioun
authors.forename: Bertrand
authors.initials: B
authors.lastname: Coiffier
authors.forename: Franck
authors.initials: F
authors.lastname: Morschhauser
mesh_terms: D000293:Adolescent; D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D000069283:Rituximab; D014750:Vincristine / Q000627:therapeutic use; D014751:Vindesine / Q000627:therapeutic use
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000970:Antineoplastic Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D001761:Bleomycin; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D014751:Vindesine; D011241:Prednisone