Quantitative and qualitative analysis of metabolic response at interim positron emission tomography scan combined with International Prognostic Index is highly predictive of outcome in diffuse large B-cell lymphoma.
The prognostic value of interim (18)fluorodeoxyglucose positron emission tomography (i-PET) was investigated in 73 patients (median age 60 years) with diffuse large B-cell lymphoma (DLBCL). i-PET was analyzed using the Deauville score (DS) and change in maximum standardized uptake value (ΔSUV(max)). Patients with a DS of 1-3 demonstrated a significantly (p < 0.0001) better outcome (median follow-up 2.4 years) than patients with a score of 4 or 5 in terms of event-free survival (EFS) (79% vs. 36%), progression-free survival (PFS) (84% vs. 47%) and overall survival (OS) (91% vs. 51%). EFS (73% vs. 42%), PFS (78% vs. 50%) and OS (88% vs. 56%) were also significantly (p = 0.023) different between patients with ΔSUV(max) > 66% or ≤ 66%. Patients (n = 33) combining a favorable age-adjusted International Prognostic Index (IPI) (0 or 1) and a negative i-PET either by DS or ΔSUV(max) criteria showed a particularly good outcome (EFS: 85%, PFS: 88%, OS: 94%). Overall, i-PET was highly and independently predictive of any outcome, and its negative predictive value was improved by combination with IPI.
Services de Médecine Nucléaire et d'Hématologie , CHU Mont-Godinne, Yvoir , Belgium.
Nathalie
N
Nols
Nicolas
N
Mounier
Salima
S
Bouazza
Renaud
R
Lhommel
Sabrina
S
Costantini
Thierry
T
Vander Borght
Marie-Christiane
MC
Vekemans
Anne
A
Sonet
André
A
Bosly
Lucienne
L
Michaux
Marc
M
André
Eric
E
Van Den Neste
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D019788:Fluorodeoxyglucose F18