title: Prognostic value of baseline total metabolic tumor volume (TMTV0) measured on FDG-PET/CT in patients with peripheral T-cell lymphoma (PTCL).
abstract: BACKGROUND
  Most peripheral T-cell lymphoma (PTCL) patients have a poor outcome and the identification of prognostic factors at diagnosis is needed.
  
  
  METHODS
  The prognostic impact of total metabolic tumor volume (TMTV0), measured on baseline [(18)F]2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography, was evaluated in a retrospective study including 108 PTCL patients (27 PTCL not otherwise specified, 43 angioimmunoblastic T-cell lymphomas and 38 anaplastic large-cell lymphomas). All received anthracycline-based chemotherapy. TMTV0 was computed with the 41% maximum standardized uptake value threshold method and an optimal cut-off point for binary outcomes was determined and compared with others prognostic factors.
  
  
  RESULTS
  With a median follow-up of 23 months, 2-year progression-free survival (PFS) was 49% and 2-year overall survival (OS) was 67%. High TMTV0 was significantly associated with a worse prognosis. At 2 years, PFS was 26% in patients with a high TMTV0 (>230 cm(3), n = 53) versus 71% for those with a low TMTV0, [P < 0.0001, hazard ratio (HR) = 4], whereas OS was 50% versus 80%, respectively, (P = 0.0005, HR = 3.1). In multivariate analysis, TMTV0 was the only significant independent parameter for both PFS and OS. TMTV0, combined with PIT, discriminated even better than TMTV0 alone, patients with an adverse outcome (TMTV0 >230 cm(3) and PIT >1, n = 33,) from those with good prognosis (TMTV0 ≤230 cm(3) and PIT ≤1, n = 40): 19% versus 73% 2-year PFS (P < 0.0001) and 43% versus 81% 2-year OS, respectively (P = 0.0002). Thirty-one patients (other TMTV0-PIT combinations) had an intermediate outcome, 50% 2-year PFS and 68% 2-year OS.
  
  
  CONCLUSIONS
  TMTV0 appears as an independent predictor of PTCL outcome. Combined with PIT, it could identify different risk categories at diagnosis and warrants further validation as a prognostic marker.
authors.affiliation: Department of Nuclear Medicine, Centre H. Becquerel and Rouen University Hospital, Rouen Department of Hematology, Centre H. Becquerel, Rouen, France.
authors.forename: A S
authors.initials: AS
authors.lastname: Cottereau
authors.affiliation: Department of Nuclear Medicine, Centre H. Becquerel and Rouen University Hospital, Rouen.
authors.forename: S
authors.initials: S
authors.lastname: Becker
authors.affiliation: Department of Hematology, Institut Paoli-Calmettes, Marseille.
authors.forename: F
authors.initials: F
authors.lastname: Broussais
authors.affiliation: Department of Hematology, Hopital Le Bocage, C.H.U Dijon.
authors.forename: O
authors.initials: O
authors.lastname: Casasnovas
authors.affiliation: Department of Nuclear Medicine, Centre GF Leclerc, Dijon.
authors.forename: S
authors.initials: S
authors.lastname: Kanoun
authors.affiliation: Department of Hematology, Hopital Le Bocage, C.H.U Dijon.
authors.forename: M
authors.initials: M
authors.lastname: Roques
authors.affiliation: Department of Nuclear Medicine, Institut Paoli-Calmettes, Marseille.
authors.forename: N
authors.initials: N
authors.lastname: Charrier
authors.affiliation: Department of Nuclear Medicine, Institut Paoli-Calmettes, Marseille.
authors.forename: S
authors.initials: S
authors.lastname: Bertrand
authors.affiliation: Department of Hematology, Hopital Necker, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Delarue
authors.affiliation: Departments of Hematology.
authors.forename: C
authors.initials: C
authors.lastname: Bonnet
authors.affiliation: Nuclear Medicine, C.H.U, ULg, Liège, Belgium.
authors.forename: R
authors.initials: R
authors.lastname: Hustinx
authors.affiliation: Department of Pathology, Groupe Henri Mondor-Albert Chenevier, Créteil Faculte de Medecine, Université Paris-Est, Créteil Unité U955, INSERM, Creteil, France.
authors.forename: P
authors.initials: P
authors.lastname: Gaulard
authors.affiliation: Institute of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: de Leval
authors.affiliation: Department of Nuclear Medicine, Centre H. Becquerel and Rouen University Hospital, Rouen QuantIF (Litis EA 418) University of Rouen, Rouen.
authors.forename: P
authors.initials: P
authors.lastname: Vera
authors.affiliation: Department of Nuclear Medicine, Groupe Henri Mondor-Albert Chenevier, Créteil.
authors.forename: E
authors.initials: E
authors.lastname: Itti
authors.affiliation: Department of Hematology, Groupe hospitalier l'Archet, Nice.
authors.forename: N
authors.initials: N
authors.lastname: Mounier
authors.affiliation: Faculte de Medecine, Université Paris-Est, Créteil Unité U955, INSERM, Creteil, France Lymphoid Malignancies Unit, Department of Hematology, Groupe Henri Mondor-Albert Chenevier, Créteil.
authors.forename: C
authors.initials: C
authors.lastname: Haioun
authors.affiliation: Department of Hematology, Centre H. Becquerel, Rouen, France.
authors.forename: H
authors.initials: H
authors.lastname: Tilly
authors.affiliation: Department of Nuclear Medicine, Groupe Henri Mondor-Albert Chenevier, Créteil michel.meignan@hmn.aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Meignan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018943:Anthracyclines / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D016411:Lymphoma, T-Cell, Peripheral / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D047368:Tumor Burden
chemical_list: D018943:Anthracyclines; D019788:Fluorodeoxyglucose F18
keywords: FDG–PET/CT; PTCL; metabolic volume