Prognostic value of (18)F-FDG PET/CT in diffuse large B-cell lymphoma treated with a risk-adapted immunochemotherapy regimen Journal Article

   


Authors: Michaud, L.; Bantilan, K.; Mauguen, A.; Moskowitz, C. H.; Zelenetz, A. D.; Schöder, H.
Article Title: Prognostic value of (18)F-FDG PET/CT in diffuse large B-cell lymphoma treated with a risk-adapted immunochemotherapy regimen
Abstract: Early identification of patients with diffuse large B-cell lymphoma (DLBCL) who are likely to experience disease recurrence or refractory disease after rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) would be useful for improving risk-adapted treatment strategies. We aimed to assess the prognostic value of 18F-FDG PET/CT parameters at baseline, interim, and end of treatment (EOT). Methods: We analyzed the prognostic impact of 18F-FDG PET/CT in 166 patients with DLBCL treated with a risk-adapted immunochemotherapy regimen. Scans were obtained at baseline, after 4 cycles of R-CHOP or 3 cycles of RR-CHOP (double dose of R) and 1 cycle of CHOP alone (interim) and 6 wk after completing therapy (EOT). Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier and the impact of clinical/PET factors assessed with Cox models. We also assessed the predictive ability of the recently proposed International Metabolic Prognostic Index (IMPI). Results: The median follow-up was 7.9 y. International Prognostic Index (IPI), baseline metabolic tumor volume (MTV), and change in maximum SUV (ΔSUVmax) at interim scans were statistically significant predictors for OS. Baseline MTV, interim ΔSUVmax, and EOT Deauville score were statistically significant predictors of PFS. Combining interim PET parameters demonstrated that patients with Deauville 4-5 and positive ΔSUVmax ≤ 70% at restaging (∼10% of the cohort) had extremely poor prognosis. The IMPI had limited discrimination and slightly overestimated the event rate in our cohort. Conclusion: Baseline MTV and interim ΔSUVmax predicted both PFS and OS with this sequential immunochemotherapy program. Combining interim Deauville score with interim ΔSUVmax may identify an extremely high-risk DLBCL population. © 2023 by the Society of Nuclear Medicine and Molecular Imaging.
Keywords: retrospective studies; prednisone; doxorubicin; rituximab; positron emission tomography; antineoplastic agent; neoplasm recurrence, local; antineoplastic combined chemotherapy protocols; cyclophosphamide; vincristine; diagnostic imaging; retrospective study; tumor recurrence; fluorodeoxyglucose f 18; fluorodeoxyglucose f18; positron-emission tomography; lymphoma, large b-cell, diffuse; diffuse large b-cell lymphoma; 18f-fdg pet/ct; diffuse large b cell lymphoma; metabolic tumor volume; humans; prognosis; human; positron emission tomography-computed tomography; positron emission tomography computed tomography; deauville score; δ-suvmax
Journal Title: Journal of Nuclear Medicine
Volume: 64
Issue: 4
ISSN: 0161-5505
Publisher: Society of Nuclear Medicine  
Date Published: 2023-04-01
Start Page: 536
End Page: 541
Language: English
DOI: 10.2967/jnumed.122.264740
PUBMED: 36549918
PROVIDER: scopus
PMCID: PMC10071786
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85152162687&doi=10.2967%2fjnumed.122.264740&partnerID=40&md5=8da1741027f3ee1e22097f7b7cbbd9d1
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Heiko Schöder --Export Date: 1 May 2023 -- Source: Scopus
Altmetric
What is Altmetric?
Citation Impact
What is Dimensions Citation Badge?
BMJ Impact Analytics
MSK Authors
  1. Heiko Schoder
    551 Schoder
  2. Andrew D Zelenetz
    781 Zelenetz
  3. Kurt Bantilan
    26 Bantilan
  4. Audrey Mauguen
    157 Mauguen
  5. Laure Michaud
    34 Michaud
Related MSK Work