title: F-18 FDG PET/CT quantization parameters as predictors of outcome in patients with diffuse large B-cell lymphoma.
abstract: OBJECTIVE
  We evaluated the prognostic significance of standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) obtained by F-18 FDG PET/CT (PET/CT) in patients with diffuse large B-cell Lymphomas (DLBCL) presenting intermediate IPI score.
  
  
  METHODS
  Fifty-two patients (61 ± 13 yr) underwent PET/CT before the first-line chemotherapy. The mean SUVmax value, the summed MTV (cm(3) ; 42% threshold), and the cumulative TLG (g) were registered. The patients were followed up 18 months thereafter (range 3-41 months). The PET/CT results were compared to the event-free survival (EFS).
  
  
  RESULTS
  At univariate analysis, SUVmax and lactate dehydrogenase (LDH) levels were predictive, but discordantly. The Kaplan-Meier survival analysis for SUVmax showed a significant better EFS in patients presenting higher values as compared to those having lesser (P = 0.0002, HR 0.13). Summed MTV and cumulative TLG were not suitable for predicting EFS.
  
  
  CONCLUSIONS
  Despite the availability of new tools for the quantitative assessment of disease activity on PET/CT, the SUVmax rather than MTV and TLG remains the only predictor for EFS in DLBCL patients. The magnitude of glycolytic activity rather than the amount of metabolically active burden holds a predominant value for determining the response to chemotherapy in DLBCL.
authors.affiliation: Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Centro di Riferimento Oncologico di Basilicata (CROB), Rionero in Vulture, Italy.
authors.forename: Rosj
authors.initials: R
authors.lastname: Gallicchio
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mansueto
authors.forename: Vittorio
authors.initials: V
authors.lastname: Simeon
authors.forename: Anna
authors.initials: A
authors.lastname: Nardelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Guariglia
authors.forename: Daniela
authors.initials: D
authors.lastname: Capacchione
authors.forename: Ernesto
authors.initials: E
authors.lastname: Soscia
authors.forename: Piernicola
authors.initials: P
authors.lastname: Pedicini
authors.forename: Domenico
authors.initials: D
authors.lastname: Gattozzi
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
authors.forename: Giovanni
authors.initials: G
authors.lastname: Storto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols; D003520:Cyclophosphamide; D018572:Disease-Free Survival; D004317:Doxorubicin; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D005500:Follow-Up Studies; D006019:Glycolysis / Q000187:drug effects; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011241:Prednisone; D011379:Prognosis; D000069283:Rituximab; D047368:Tumor Burden / Q000187:drug effects; D014750:Vincristine
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D019788:Fluorodeoxyglucose F18; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: DLBCL; PET/CT; glycolytic activity; quantitative assessment; survival