title: Prognostic value of negative interim 2-[¹⁸F]-fluoro-2-deoxy-d-glucose PET/CT in diffuse large B-cell lymphoma.
abstract: OBJECTIVE
  To assess the prognostic value of negative interim combined 2-[(18)F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) positron-emission tomography/computed tomography (PET/CT) in patients with diffuse large B-cell lymphoma (DLBCL).
  
  
  METHODS
  Ninety-two patients with histologically proven DLBCL were enrolled. All of the patients underwent (18)F-FDG PET/CT at diagnosis, and interim PET/CT after the second cycle of chemotherapy with rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisolone (R-CHOP). Negative interim PET/CT was defined as the disappearance of all abnormal (18)F-FDG uptake compared to the pretreatment PET/CT image, as determined by visual assessment. The clinical outcome of patients was estimated as progression-free survival (PFS), and the prognostic significance of clinicopathological and imaging parameters were assessed using the Cox proportional hazards model.
  
  
  RESULTS
  Thirty-six patients (39.1%) showed lymphoma progression within a median follow-up of 30.8 months. According to univariate analysis, Ann Arbor stage, serum lactate dehydrogenase level, Eastern Cooperative Oncology Group scale, International Prognostic Index (IPI) score, and maximum standardised uptake values on initial PET/CT were significant prognostic factors for PFS (all p<0.05). Among these parameters, only the IPI score was an independent predictor for PFS (p=0.044). Survival of patients with a high IPI score (≥3) was poorer than those with a low IPI score (0-2; p<0.001).
  
  
  CONCLUSIONS
  Despite a negative interim (18)F-FDG PET/CT, approximately 39% of DLBCL patients showed progression during follow-up. Although the negative PET/CT was obtained during chemotherapy, it is important to closely follow-up patients, especially those with a high IPI score.
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Kwon
authors.affiliation: Department of Medical Humanities & Social Medicine, Ajou University School of Medicine, Suwon, South Korea; Office of Biostatistics, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: D R
authors.initials: DR
authors.lastname: Kang
authors.affiliation: Office of Biostatistics, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: J
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: J-K
authors.initials: JK
authors.lastname: Yoon
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: S J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Jeong
authors.affiliation: Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, South Korea.
authors.forename: H W
authors.initials: HW
authors.lastname: Lee
authors.affiliation: Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea. Electronic address: aysays77@naver.com.
authors.forename: Y-S
authors.initials: YS
authors.lastname: An
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18