title: Tumor Burden Assessed by the Maximum Standardized Uptake Value and Greatest Diameter on FDG-PET Predicts Prognosis in Untreated Diffuse Large B-cell Lymphoma.
abstract: OBJECTIVE
  It is uncertain whether the tumor burden as assessed using FDG-PET has prognostic significance in newly diagnosed diffuse large B-cell lymphoma (DLBCL). The authors undertook this study to determine whether a parameter that reflects both FDG uptake magnitude and the greatest tumor diameter is a prognostic indicator in DLBCL.
  
  
  METHODS
  Forty-two DLBCL patients (age, 57.4 ± 15.5 years; male/female = 25/17; stage I/II/III/IV=5/17/10/10) who underwent FDG-PET before chemotherapy were enrolled. A lesion with the highest maximum standardized uptake value (MaxSUV) on the PET image was selected, and size-incorporated MaxSUV (SIMaxSUV) of mass was calculated as MaxSUV × greatest diameter (mm) on the transaxial PET image. Median follow-up duration was 20.0 months.
  
  
  RESULTS
  Twelve (28.6% = 12/42) patients experienced disease progression, and 10 (23.8% = 10/42) died during follow-up. Among six variables [Ann Arbor stage, %Ki-67 expression, International Prognostic Index (IPI), MaxSUV, greatest diameter, and SIMaxSUV] investigated, only SIMaxSUV was found to be a single determinant of progression-free and overall survivals by multivariate analyses (p < 0.05).
  
  
  CONCLUSIONS
  These results suggest that SIMaxSUV, a new FDG-PET parameter that incorporates FDG uptake magnitude and the greatest tumor diameter, may be a useful indicator of prognosis in untreated DLBCL.
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707 Korea ; Department of Nuclear Medicine, Cho Ray Hospital, Ho Chi Minh City, Viet Nam.
authors.forename: Xuan Canh
authors.initials: XC
authors.lastname: Nguyen
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707 Korea ; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
authors.forename: Won Woo
authors.initials: WW
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707 Korea ; Department of Nuclear Medicine Diagnosis and Therapy, Cairo University, Cairo, Egypt.
authors.forename: Amr Mohamed
authors.initials: AM
authors.lastname: Amin
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707 Korea.
authors.forename: Jae Seon
authors.initials: JS
authors.lastname: Eo
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Soo-Mee
authors.initials: SM
authors.lastname: Bang
authors.affiliation: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707 Korea ; Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Kim
keywords: FDG-PET; Greatest diameter; Lymphoma; Prognosis; SUV; Size-incorporated maxSUV