scholarly journals PET metabolic tumor volume as a new prognostic factor in childhood rhabdomyosarcoma

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261565
Author(s):  
Helio Fayolle ◽  
Nina Jehanno ◽  
Valerie Lauwers-Cances ◽  
Marie-Pierre Castex ◽  
Daniel Orbach ◽  
...  
Keyword(s):  
Tumor Volume ◽  
Primary Tumour ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Distant Metastases ◽  
Metabolic Tumor Volume ◽  
University Hospitals ◽  
Prognostic Accuracy ◽  
Tumour Spread ◽  
Bone Lysis

Purpose Childhood RMS is a rare malignant disease in which evaluation of tumour spread at diagnosis is essential for therapeutic management. F-18 FDG-PET imaging is currently used for initial RMS disease staging. Materials and methods This multicentre retrospective study in six French university hospitals was designed to analyse the prognostic accuracy of MTV at diagnosis for patients with RMS between 1 January 2007 and 31 October 2017, for overall (OS) and progression-free survival (PFS). MTV was defined as the sum of the primitive tumour and the largest metastasis, where relevant, with a 40% threshold of the primary tumour SUVmax. Additional aims were to define the prognostic value of SUVmax, SUVpeak, and bone lysis at diagnosis. Results Participants were 101 patients with a median age of 7.4 years (IQR [4.0-12.5], 62 boys), with localized disease (35 cases), regional nodal spread (43 cases), or distant metastases (23). 44 patients had alveolar subtypes. In a univariate analysis, a MTV greater than 200 cm3 was associated with OS (HR = 3.47 [1.79;6.74], p<0.001) and PFS (HR = 3.03 [1.51;6.07], p = 0.002). SUVmax, SUVpeak, and bone lysis also influenced OS (respectively p = 0.005, p = 0.004 and p = 0.007) and PFS (p = 0.029, p = 0.019 and p = 0.015). In a multivariate analysis, a MTV greater than 200 cm3 was associated with OS (HR = 2.642 [1.272;5.486], p = 0.009) and PFS (HR = 2.707 [1.322;5.547], p = 0.006) after adjustment for confounding factors, including SUVmax, SUVpeak, and bone lysis. Conclusion A metabolic tumor volume greater than 200 cm3, SUVmax, SUVpeak, and bone lysis in the pre-treatment assessment were unfavourable for outcome.

Total tumor burden in lymphoma – an evolving strong prognostic parameter

2021 ◽  
pp. 20210448
Author(s):  
Michel Meignan ◽  
Anne-Segolene Cottereau ◽  
Lena Specht ◽  
N. George Mikhaeel
Keyword(s):  
Tumor Volume ◽  
Cell Lymphoma ◽  
Strong Predictor ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Risk Groups ◽  
Metabolic Tumor Volume ◽  
Tumor Burden ◽  
Interim Pet ◽  
Fdg Pet Ct

Total metabolic tumor volume (TMTV), a new parameter extracted from baseline FDG-PET/CT, has been recently proposed by several groups as a prognosticator in lymphomas before first-line treatment. TMTV, the sum of the metabolic volume of each lesion, is an index of the metabolically most active part of the tumor and highly correlates with the total tumor burden. TMTV measurement is obtained from PET images processed with different software and techniques, many being now freely available. In the various lymphoma subtypes where it has been measured, such as diffuse large B-cell lymphoma, Hodgkin lymphoma, Follicular Lymphoma, and Peripheral T-cell lymphoma, TMTV has been reported as a strong predictor of outcome (progression-free survival and overall survival) often outperforming the clinical scores, molecular predictors, and results of interim PET. Combined with these scores, TMTV improves the stratification of the populations into risk groups with different outcomes. TMTV cut-off separating the high-risk from the low-risk population impacts the outcome whatever the technique used for its measurement and an international harmonization is ongoing. TMTV is a unique and easy tool that could replace the surrogate of tumor burden included in the prognostic indexes used in lymphoma and help tailor therapy. Other parameters extracted from the baseline PET may give an information on the dissemination of this total tumor volume such as the maximum distance between the lesions. Trials based on TMTV would probably demonstrate its predictive value.

scholarly journals Tumor metabolic volume by 18F-FDG-PET as a prognostic predictor of first-line pembrolizumab for NSCLC patients with PD-L1 ≥ 50%

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ou Yamaguchi ◽  
Kyoichi Kaira ◽  
Kosuke Hashimoto ◽  
Atsuto Mouri ◽  
Ayako Shiono ◽  
...  
Keyword(s):  
Objective Response ◽  
Prognostic Significance ◽  
Standardized Uptake Value ◽  
Progression Free Survival ◽  
Predictive Marker ◽  
Distant Metastases ◽  
Metabolic Tumor Volume ◽  
First Line ◽  
Prognostic Predictor ◽  
Fdg Uptake

Abstract There is a lack of markers for predicting favorable outcomes after pembrolizumab therapy in patients with non-small cell lung cancer (NSCLC) with programmed death ligand-1 (PD-L1) expression ≥ 50%. This retrospective study examined the prognostic significance of 2-deoxy-2-[18F] fluoro-d-glucose (18F-FDG) uptake as a predictive marker of first-line pembrolizumab. Forty-eight patients with previously untreated NSCLC and PD-L1 expression levels ≥ 50% who underwent 18F-FDG-positron emission tomography (PET) just before administration of pembrolizumab monotherapy were eligible and underwent assessment of metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum of standardized uptake value (SUVmax) on 18F-FDG uptake. The objective response rate, median progression-free survival, and median overall survival were 51.1%, 7.1 months, and 18.6 months, respectively. In univariate survival analyses, high MTV was barely a significant prognostic predictor and was confirmed as an independent factor linked to worse outcomes in multivariate analysis, predominantly in patients with a histological diagnosis of adenocarcinoma. A high MTV was significantly associated with distant metastases (especially bone metastasis), C-reactive protein (CRP) level, and PD-L1 expression ≥ 75%. Metabolic tumor activity assessed as MTV from 18F-FDG uptake predicted the prognosis after first-line pembrolizumab treatment in patients with NSCLC and PD-L1 expression ≥ 50%, especially for adenocarcinoma.

scholarly journals Prognostic Value of Metabolic Tumor Volume on 11C-Methionine PET in Predicting Progression-Free Survival in High-Grade Glioma

2015 ◽  
Vol 49 (4) ◽  
pp. 291-297 ◽  
Author(s):  
Min Young Yoo ◽  
Jin Chul Paeng ◽  
Gi Jeong Cheon ◽  
Dong Soo Lee ◽  
June-Key Chung ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Tumor Volume ◽  
Progression Free Survival ◽  
High Grade Glioma ◽  
Metabolic Tumor Volume ◽  
High Grade ◽  
Free Survival

CXCR4 and RIF1 Overexpression Induces Resistance of Epithelial Ovarian Cancer to Cisplatin

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 31-31
Author(s):  
Lamiss Mohamed Abd El Aziz ◽  
Dareen Mohamed Abd El Aziz ◽  
Assama Elkady ◽  
Noha Elanwar
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Epithelial Ovarian Cancer ◽  
Progression Free Survival ◽  
Distant Metastases ◽  
Dna Breaks ◽  
University Hospitals ◽  
Double Strand Dna Breaks ◽  
Cisplatin Sensitivity ◽  
Novel Biomarkers

The chemoresistance of epithelial ovarian cancer (EOC) is a major problem Thus, the search for novel biomarkers associated with cisplatin sensitivity is overwhelming. Previous studies have shown that chemokine receptor (CXCR4) is associated with tumor growth, angiogenesis and distant metastases and replication regulatory timing factor (RIF1) is responsible for repair of double strand DNA breaks. This study, thus, aimed to identify the correlation between CXCR4 and RIF1 overexpression and cisplatin sensitivity in EOC. Patients and methods: Fifty five EOC patients were recruited to assess chemosensitivity of EOC to cisplatin based chemotherapy in Oncology Department, Tanta University Hospitals. Results: The results showed that patients with a higher CXCR4 and RIF1 expression exhibited a significantly lower chemosensitivity, worse overall survival and a poorer progression-free survival. The only prognostic associated with overall survival was CXCR4.

scholarly journals The Management of Radiation-Induced Sarcomas: A Cohort Analysis from a Sarcoma Tertiary Center

2021 ◽  
Vol 10 (4) ◽  
pp. 694
Author(s):  
Mateusz Jacek Spałek ◽  
Anna Małgorzata Czarnecka ◽  
Piotr Rutkowski
Keyword(s):  
Background Radiation ◽  
Cohort Analysis ◽  
Univariate Analysis ◽  
Progression Free Survival ◽  
Distant Metastases ◽  
Curative Intent ◽  
Factors Affecting ◽  
Risk Of Death ◽  
Tertiary Center ◽  
Radiation Induced

(1) Background: Radiation-induced sarcomas (RIS) are rare diseases with poor prognoses. The aim of the study was to analyze outcomes and identify factors affecting survival in a cohort of patients with RIS. (2) Methods: We included consecutive patients with RIS that we found in the available electronic medical records of a sarcoma tertiary center. We analyzed patients’ RIS characteristics, management of RIS, the occurrence of local recurrence and distant metastases, the date of disease progression, the date of death, and the date of the last follow-up. (3) Results: Fifty-eight patients met the inclusion criteria. The most frequent sites of RIS development were the thorax and pelvis. The majority of RIS were poorly differentiated, high-grade tumors. Forty patients underwent surgery or radiotherapy with curative intent. The others were referred to palliative chemotherapy. Median progression-free survival and overall survival were 15 and 21 months, respectively. Treatment with curative intent and tumor localization on breasts and upper extremities were associated with a lower risk of death in univariate analysis. (4) Conclusions: The study confirms the poor prognosis of RIS. Treatments with locally curative intent at the tumor site are of prognostic value. Secondary radiotherapy is rarely used in RIS.

Tumor volume as a prognostic factor in patients (pts) with locoregionally advanced head and neck squamous cell carcinoma (LAHNSCC) treated with induction chemotherapy (IC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17507-e17507
Author(s):  
Daniel Moore Freitas Palhares ◽  
Fernando Coutinho Batista ◽  
Ana Lima Veneziani ◽  
Marcos Duarte Mattos ◽  
Augusto Elias Mamere ◽  
...  
Keyword(s):  
Head And Neck ◽  
Tumor Volume ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Primary Site ◽  
Planning System ◽  
Treatment Planning System ◽  
Definitive Treatment ◽  
Volumetric Change

e17507 Background: Tumor volume and the ratio of volumetric change have been demonstrated to have a prognostic role in head and neck cancers during definitive treatment in LAHNSCC. The aim of this study was to evaluate the prognostic value of tumor volume assessment during IC. Methods: We retrospectively assessed the tumor volume of 58 pts with LAHNSCC included in a prospective phase II trial which evaluated the safety of a non–5-fluorouracil-based IC (paclitaxel; cisplatin) followed by chemoradiotherapy (cisplatin; 70Gy/35fx) during 2009-2012. The volume of primary tumor (PrimV), all suspicious lymph nodes (LNV) and their sum (SumV) were determined on tomography before (CT1) and after (CT2) IC using a radiotherapy treatment planning system and the ratio of volumetric change was calculated for each variable (PrimV%, LNV% and SumV%). Results: The median follow-up time, the progression free survival (PFS) and the overall survival (OS) was 78,1, 19,3 and 22,5 months, respectively. Fifty-four pts were men, mean age 55,3±8,3y. Most had oropharynx (53%) and stage IV (72%) cancer. The median volume (cm3) was PrimV1= 25,5, LNV1= 7,5, SumV1= 40,7, PrimV2= 10,9, LNV2= 3,0, SumV2= 18,8 and median ratio of change (%) was PrimV% = 55, LNV% = 51 and SumV% = 54. Volume wa s associated with resectability (PrimV1, AUC ROC curve = 0,66, p = 0,04; LNV1, AUC = 0,85, p < 0,001; SumV1, AUC = 0,86, p < 0,001). Pts with SumV% reduction > 35% had better PFS (median 84,0 vs 10,1 months, 3y 52% vs 29%; HR = 0,39, p = 0,01) and OS (median 45,5 vs 17,0 months, 48% vs 21%; HR = 0,49, p = 0,04). On univariate analysis the PFS was correlated with T (p = 0,004), N (p = 0,01), stage (p = 0,03), primary site (p = 0,01), resectability (HR = 0,32, p = 0,001), PrimV1 (p = 0,002), SumV1 (p = 0,001), PrimV2 (p = 0,02), LNV2 (p = 0,04), SumV2 (p = 0,004), PrimV% (p = 0,04), LNV% (p = 0,003) and SumV% (p = 0,04) and OS was associated with T (p = 0,04), N (p = 0,02), stage (p = 0,04), primary site (p = 0,01), resectability (HR = 0,29, p < 0,001) PrimV1 (p = 0,003), LNV1 (p = 0,002) and SumV1 (p < 0,001). Conclusions: Tumor volume and the volumetric response during IC were associated with prognosis in LAHNSCC in the present study. Clinical trial information: NCT00959387.

scholarly journals Total metabolic tumor volume as a survival predictor for patients with diffuse large B-cell lymphoma in the GOYA study

Haematologica ◽  
2021 ◽  
Author(s):  
Lale Kostakoglu ◽  
Federico Mattiello ◽  
Maurizio Martelli ◽  
Laurie H. Sehn ◽  
David Belada ◽  
...  
Keyword(s):  
B Cell ◽  
Tumor Volume ◽  
Standardized Uptake Value ◽  
Progression Free Survival ◽  
B Cell Lymphoma ◽  
Metabolic Tumor Volume ◽  
Total Lesion Glycolysis ◽  
Free Survival ◽  
Large B Cell Lymphoma ◽  
Large B Cell

This retrospective analysis of the phase III GOYA study investigated the prognostic value of baseline metabolic tumor volume parameters and maximum standardized uptake values for overall and progression-free survival in treatment-naïve diffuse large B-cell lymphoma. Baseline total metabolic tumor volume (determined for tumors >1 mL using a threshold of 1.5 times the mean liver standardized uptake value +2 standard deviations), total lesion glycolysis, and maximum standardized uptake value positron emission tomography data were dichotomized based on receiver operating characteristic analysis and divided into quartiles by baseline population distribution. Of 1,418 enrolled patients, 1,305 had a baseline positron emission tomography scan with detectable lesions. Optimal cut-offs were 366 cm3 for total metabolic tumor volume and 3,004g for total lesion glycolysis. High total metabolic tumor volume and total lesion glycolysis predicted poorer progression-free survival, with associations retained after adjustment for baseline and disease characteristics (high total metabolic tumor volume hazard ratio: 1.71 [95% CI, 1.35–2.18]; total lesion glycolysis hazard ratio: 1.46 [95% CI, 1.15–1.86]). Total metabolic tumor volume was prognostic for progression-free survival in subgroups with International Prognostic Index scores 0–2 and 3–5, and those with different cell-of-origin subtypes. Maximum standardized uptake value had no prognostic value in this setting. High total metabolic tumor volume associated with high International Prognostic Index or non-germinal center B-cell classification identified the highest-risk cohort for unfavorable prognosis. In conclusion, baseline total metabolic tumor volume and total lesion glycolysis are independent predictors of progression-free survival in patients with diffuse large B-cell lymphoma after first-line immunochemotherapy.

scholarly journals Prognostic Value of Pretherapeutic Primary Tumour MTV from [18F]FDG PET in Radically Treated Cervical Cancer Patients

Metabolites ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 809
Author(s):  
Paulina Cegla ◽  
Frank Hofheinz ◽  
Witold Cholewiński ◽  
Rafał Czepczyński ◽  
Anna Kubiak ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Fdg Pet ◽  
Primary Tumour ◽  
Standardized Uptake Value ◽  
Distant Metastases ◽  
Metabolic Tumor Volume ◽  
Cutoff Point ◽  
Disease Stage ◽  
18F Fdg

The aim of this study was to assess the usefulness of pretherapeutic primary tumor metabolic tumor volume (MTV) in the prognosis of radically treated cervical cancer patients. Retrospective, single-centre analysis was performed on a group of 508 cervical cancer patients. All patients underwent a pretreatment [18F]FDG PET/CT study for the assessment of the disease stage. Several PET-derived parameters—namely, maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), total lesion glycolysis (TLG) and MTV, as well as the clinical parameters, were analysed in terms of the overall survival (OS), event-free survival (EFS), locoregional control (LRC) and freedom from distant metastases (FFDM). Hyperthermia and brachytherapy were prognostic for EFS, OS, and LRC.FIGO stage > II showed a significant effect on EFS, OS, and FFDM. Moreover, hysterectomy was prognostic for OS and histology was prognostic for FFDM. From the PET-derived parameters only MTV of the primary tumour had a significant influence on OS (cutoff point: >12.7 mL, HR: 2.8, 1.75–4.48 95% CI, p < 0.001), LRC (cutoff point: >13.7 mL, HR 2.82, 1.42–5.61 95% CI, p = 0.003), EFS (cutoff point: >10.4 mL, HR: 2.57, 1.67–3.97 95% CI, p < 0.001) and FFDM (cutoff point: >10.4 mL, HR: 5.04, 1.82–13.99 95%CI, p = 0.002). The pretreatment of MTV in primary tumour is the only independent prognostic parameter in OS, LRC, EFS, and FFDM in radically treated cervical cancer patients and should be used in clinical practice in assessing prognosis in these patients.

FDG-PET/CT Metabolic Tumor Volume: A New Prognostic Marker in Hodgkin Lymphoma?

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3632-3632
Author(s):  
Marine Boulesteix ◽  
Mohamed Touati ◽  
Julie Abraham ◽  
Sandrine Verbeke ◽  
Assmae El Badaoui ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Tumor Volume ◽  
Univariate Analysis ◽  
Metabolic Tumor Volume ◽  
Large Tumor ◽  
Pet Ct ◽  
The Mean ◽  
Fdg Pet Ct ◽  
Large Tumor Volume

Abstract Abstract 3632 Introduction: Although Hodgkin Lymphoma (HL) is highly curable, about 15% of patients (pts) are refractory or relapsed after first line treatment. Classic prognostic scores (e.g. IPS) are useful for identifying high risk pts, who need intensive treatment, and low risk pts, who beneficiate de-escalation to minimize side effects. However, they are not enough suitable to predict outcomes. Consequently, finding new complementary tools for detecting refractory or relapsing pts, remains a challenge. Fluorodeoxyglucose (FDG)-PET/CT involvement in initial staging has been widely studied. Although clinical or CT tumor volume is an important prognostic factor, metabolic tumor volume (MTV) is not enough explored. We performed a study to 1) determine whether MTV and maximum standardized uptake value (SUV) max could be new prognostic markers and 2) compare metabolic tissue heterogeneity with CD68 expression, a promising new prognostic factor linked with inflammatory microenvironment. Patients and methods: Among 456 histologically proven HL pts registered in the Regional Lymphoma database of Limousin (SRRLL, France) since 1990's, 158 have an available sample for CD68 staining. Among the 106 pts who have undergone FDG-PET, 43 pts have available quantitative initial and early response (post-C2) SUV FDG-PET/CT data. The median follow-up was 21 months (6–72.5). Pts were classified following Ann Arbor stages I: 4 pts, II: 17 pts, III: 9 pts, IV: 13 pts. FDG-PET/CT exams were performed with a biograph6 Siemens® device and analyzed with Siemens MI® application. MTV was computed for all pts with a 2D delineation technique and using a thresholding method. The threshold (T) corresponds to mean liver SUV (+3 sd) calculated into 50 cm3 of normal liver. All the tumor voxels (3D pixels) equal or greater than the T belong to MTV. MTV per pathological area (MTVa) was also analyzed. Pts with spleen lesions have an increased volume compared to the others. To minimize spleen's impact, MTV was calculated without spleen (MTVws). Quantitative FDG uptake is routinely measured by SUVmax. The mean SUVmax was also worked out into 1 cm3 around the tumor SUVmax. ROC curves were plotted for continuous variables such as age, erythrocyte sedimentation rate (ESR), MTV, SUVmax and mean SUVmax. CD68, tumor associated macrophage expression, was tested with a 25% threshold for positivity. Significant factors allowed dividing pts into favorable and unfavorable groups. Event free survival (EFS) studies were carried out for all binary variables using COX model. A univariate regression analysis was performed. Variables with a p<0.20 were included in multivariate analysis. Results: Median age and sex ratio (n=43) were respectively 29 y-o (16–77) and 0.87. ROC and univariate analysis showed that MTV, MTVa and MTVws were significant predictors for absence of complete remission (CR) at post-C2 and EFS. Cut-off values for prognosis (Cp) were 310 cm3 for MTV or MTVws and 53 cm3 for MTVa (p<0.001). Cut-off values for post-C2 were 244 cm3 for MTV or MTVws and 62 cm3 for MTVa (p<0.007). For pts with a large tumor volume (MTV, MTVws or MTVa > Cp), 1 and 2 years EFS were shorter (figure1). Two years EFS for MTV, MTVa and MTVws are respectively: 40%, 50% and 21% for large tumor volume and 87%, 86% and 89% for small tumor volume (p= 0.004, p=0.01 and p=0.0003). The mean SUVmax and heterogeneity were significant in univariate analysis (p=0.01 and p=0.04) but not in ROC analysis. Heterogeneity level was not correlated with CD68 expression. Each new parameter was compared, in multivariate analysis, to ESR, stages, B symptoms, bulky, age. MTV was an independent factor for predicting outcomes and post-C2 results (p<0.01) and better than mean SUV max. Similar results were found for MTVa and MTVws (p<0.02 and p<0.01). Discussion: In spite of limited number of pts and short follow-up, prognostic value of MTV is very significant. Those data are in accordance with the few results previously reported (Hutchings et al. Int J Radiat Oncol Biol Phys, 2005). Song et al. (Cancer Science, 2012) also highlighted that MTV was better predictor than SUVmax in DLBCL. Conclusion: Large MTV seems to be a potential predictive marker for adverse post-C2 results and EFS. These data need further studies to confirm, in larger cohort, these first promising results to establish a better initial risk stratification of pts, leading to optimal adaptive therapy strategy. Disclosures: No relevant conflicts of interest to declare.

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