Methodological Aspects of Measuring Metabolic Tumor Volume in Patients with Diffuse B-Cell Large Cell Lymphoma by PET/CT with 18F-FDG

Introduction: Metabolic Tumor Volume (MTV) and Total Tumor Lesion Glycolysis (TLG) are used in 18F-fluorodeoxyglucose Positron-Emission Tomography combined with Computed Tomography (18F-FDG PET/CT) as functional markers, indicating tracer uptake in whole tumor. MTV and TLG are not yet engaged in clinical practice, because volume measurement accuracy depends on the selected measurement method, and optimal MTV and TLG segmentation is not established.Purpose: Assessment of accuracy of metabolic tumor volume measurement ways, using 18F-FDG PET/CT in patients with Diffuse Large B-Cell Lymphoma (DLBCL).Material and methods: Baseline 18F-FDG PET/CT performed in 21 patients with DLBCL. Tumor Volume (TV), measured on contrast enhanced CT (CTTV), considered as reference. While measuring MTV, we aimed to achieve a 1:1 ratio between CTTV and MTV. If anatomical and metabolic tumor contours matched, MTV was considered true (MTVtrue). Overall MTV and TLG measurements are 254. Tumor contouring, using relative thresholds, was made around Standardized Uptake Value (SUVmax) of tracer in tumor and intact liver.Results: On CT, the size of the lesions varied from 24 to 241 mm, M = 103.4±62.3, Me = 93 (48.5–155.5). In 15 (71.4 %) foci, hypodense areas of necrosis were determined. PET imaging revealed high tracer uptake in all foci of varying degrees of intensity. SUVmax values in tumors ranged from 5.8 to 30.5, Me = 20.4 (17.3–23.2). No significant correlation was found between the size of the foci and SUVmax (ρ = 0.17, p = 0.4744). The best accuracy in measuring MTV was observed when several thresholds were applied: VOIPERCIST, VOI2.5, VOIauto-contour, as well as VOI10 %, VOI15 % and VOI20 %. The optimal absolute threshold values were SUV values in the range from 2 to 3, and relative values in the range from 10 % to 20 % of the SUVmax in the tumor. MTV underestimation was more often determined using relative cut-off indices in the range of25–50 % and SUV thresholds ≥ 5.3.Conclusion: The results obtained showed that the use of a single threshold value for MTV segmentation in patients with DLBCL is not advisable. The choice of the MTV measurement method should be carried out individually for each lesion, taking into account its shape, size and structure, as well as the intensity and uniformity of tracer uptake in the tumor and adjacent anatomical structures.

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Molecular Profile and FDG-PET/CT Total Metabolic Tumor Volume Improve Risk Classification at Diagnosis for Patients with Diffuse Large B-Cell Lymphoma

Clinical Cancer Research ◽

10.1158/1078-0432.ccr-15-2825 ◽

2016 ◽

Vol 22 (15) ◽

pp. 3801-3809 ◽

Cited By ~ 72

Author(s):

Anne-Ségolène Cottereau ◽

Hélène Lanic ◽

Sylvain Mareschal ◽

Michel Meignan ◽

Pierre Vera ◽

...

Keyword(s):

B Cell ◽

Tumor Volume ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Metabolic Tumor Volume ◽

Molecular Profile ◽

Large B Cell Lymphoma ◽

Pet Ct ◽

Fdg Pet Ct ◽

Large B Cell

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Baseline Total Metabolic Tumor Volume Combined with International Peripheral T-Cell Lymphoma Project may Improve Prognostic Stratification for Patients with Peripheral T-Cell Lymphoma (PTCL)

10.21203/rs.3.rs-38884/v1 ◽

2020 ◽

Author(s):

Chong Jiang ◽

Yue Teng ◽

Jieyu Chen ◽

Zhen Wang ◽

Zhengyang Zhou ◽

...

Keyword(s):

T Cell ◽

Fdg Pet ◽

Tumor Volume ◽

Cell Lymphoma ◽

Standardized Uptake Value ◽

Metabolic Tumor Volume ◽

T Cell Lymphoma ◽

Peripheral T Cell Lymphoma ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Purpose: The aim of this study was to explore the prognostic value of total metabolic tumor volume (TMTV) at baseline 18F-FDG PET/CT in patients diagnosed with peripheral T-cell lymphoma (PTCL).Materials and methods: Eighty-four PTCL patients who underwent baseline 18F-FDG PET/CT between March 2009 and January 2019 and did not receive treatment were enrolled in this retrospective study. The FDG-avid lesions in each patient were segmented using semiautomated software to calculate the maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG) values using the boundaries of voxels presenting with the 41% SUVmax threshold method. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate patient prognosis. The log-rank test and Cox regression analyses were used to evaluate PFS and OS.Results: ROC curve analysis indicated an ideal TMTV cut-off value of 228.8 cm3. During the 4-131month (29.2±28.5 months) follow-up period, high TMTV was significantly associated with worse PFS and OS. TMTV and the international peripheral T-cell lymphoma project score (IPTCLP) were independent predictors of PFS and OS with multivariate analysis. The combination of TMTV and the IPTCLP may provide significantly better risk substratification in PFS and OS of PTCL patients.Conclusions: Both TMTV and IPTCLP are independent predictors of PTCL patient survival outcomes. Moreover, the combination of TMTV and IPTCLP improved patient risk stratification and may contribute to personalized therapeutic regimens.

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Prognostic value of baseline total metabolic tumor volume (TMTV0) measured on FDG-PET/CT in patients with peripheral T-cell lymphoma (PTCL)

Annals of Oncology ◽

10.1093/annonc/mdw011 ◽

2016 ◽

Vol 27 (4) ◽

pp. 719-724 ◽

Cited By ~ 40

Author(s):

A.S. Cottereau ◽

S. Becker ◽

F. Broussais ◽

O. Casasnovas ◽

S. Kanoun ◽

...

Keyword(s):

T Cell ◽

Fdg Pet ◽

Prognostic Value ◽

Tumor Volume ◽

Cell Lymphoma ◽

Metabolic Tumor Volume ◽

T Cell Lymphoma ◽

Peripheral T Cell Lymphoma ◽

Pet Ct ◽

Fdg Pet Ct

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Baseline total metabolic tumor volume combined with international peripheral T-cell lymphoma project may improve prognostic stratification for patients with peripheral T-cell lymphoma (PTCL)

EJNMMI Research ◽

10.1186/s13550-020-00698-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Chong Jiang ◽

Yue Teng ◽

Jieyu Chen ◽

Zhen Wang ◽

Zhengyang Zhou ◽

...

Keyword(s):

T Cell ◽

Fdg Pet ◽

Tumor Volume ◽

Cell Lymphoma ◽

Standardized Uptake Value ◽

Metabolic Tumor Volume ◽

T Cell Lymphoma ◽

Peripheral T Cell Lymphoma ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Purpose The aim of this study was to explore the prognostic value of total metabolic tumor volume (TMTV) at baseline 18F-FDG PET/CT in patients diagnosed with peripheral T-cell lymphoma (PTCL). Materials and methods Eighty-four newly diagnosed PTCL patients who underwent baseline 18F-FDG PET/CT prior to treatment between March 2009 and January 2019 were enrolled in this retrospective study. The FDG-avid lesions in each patient were segmented using semiautomated software to calculate the maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG) values using the boundaries of voxels presenting with the 41% SUVmax threshold method. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate patient prognosis. The log-rank test and Cox regression analyses were used to evaluate PFS and OS. Results ROC curve analysis indicated an ideal TMTV cut-off value of 228.8 cm3. During the 4–131 months (29.2 ± 28.5 months) follow-up period, high TMTV was significantly associated with worse PFS and OS. TMTV and the international peripheral T-cell lymphoma project score (IPTCLP) were independent predictors of PFS and OS with multivariate analysis. The combination of TMTV and the IPTCLP may provide significantly better risk substratification in PFS and OS of PTCL patients. Conclusions Both TMTV and IPTCLP are independent predictors of PTCL patient survival outcomes. Moreover, the combination of TMTV and IPTCLP improved patient risk stratification and may contribute to personalized therapeutic regimens.

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Baseline total metabolic tumor volume combined with international peripheral T-cell lymphoma project may improve prognostic stratification for patients with peripheral T-cell lymphoma (PTCL)

10.21203/rs.3.rs-38884/v2 ◽

2020 ◽

Author(s):

Chong Jiang ◽

Yue Teng ◽

Jieyu Chen ◽

Zhen Wang ◽

Zhengyang Zhou ◽

...

Keyword(s):

T Cell ◽

Fdg Pet ◽

Tumor Volume ◽

Cell Lymphoma ◽

Standardized Uptake Value ◽

Metabolic Tumor Volume ◽

T Cell Lymphoma ◽

Peripheral T Cell Lymphoma ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Purpose: The aim of this study was to explore the prognostic value of total metabolic tumor volume (TMTV) at baseline 18F-FDG PET/CT in patients diagnosed with peripheral T-cell lymphoma (PTCL).Materials and methods: Eighty-four newly diagnosed PTCL patients who underwent baseline 18F-FDG PET/CT prior to treatment between March 2009 and January 2019 were enrolled in this retrospective study. The FDG-avid lesions in each patient were segmented using semiautomated software to calculate the maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG) values using the boundaries of voxels presenting with the 41% SUVmax threshold method. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate patient prognosis. The log-rank test and Cox regression analyses were used to evaluate PFS and OS.Results: ROC curve analysis indicated an ideal TMTV cut-off value of 228.8 cm3. During the 4-131 month (29.2±28.5 months) follow-up period, high TMTV was significantly associated with worse PFS and OS. TMTV and the international peripheral T-cell lymphoma project score (IPTCLP) were independent predictors of PFS and OS with multivariate analysis. The combination of TMTV and the IPTCLP may provide significantly better risk substratification in PFS and OS of PTCL patients.Conclusions: Both TMTV and IPTCLP are independent predictors of PTCL patient survival outcomes. Moreover, the combination of TMTV and IPTCLP improved patient risk stratification and may contribute to personalized therapeutic regimens.

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Baseline total metabolic tumor volume combined with international peripheral T-cell lymphoma project may improve prognostic stratification for patients with peripheral T-cell lymphoma (PTCL)

10.21203/rs.3.rs-38884/v3 ◽

2020 ◽

Author(s):

Chong Jiang ◽

Yue Teng ◽

Jieyu Chen ◽

Zhen Wang ◽

Zhengyang Zhou ◽

...

Keyword(s):

T Cell ◽

Fdg Pet ◽

Tumor Volume ◽

Cell Lymphoma ◽

Standardized Uptake Value ◽

Metabolic Tumor Volume ◽

T Cell Lymphoma ◽

Peripheral T Cell Lymphoma ◽

Pet Ct ◽

Fdg Pet Ct

Abstract Purpose: The aim of this study was to explore the prognostic value of total metabolic tumor volume (TMTV) at baseline 18F-FDG PET/CT in patients diagnosed with peripheral T-cell lymphoma (PTCL).Materials and methods: Eighty-four newly diagnosed PTCL patients who underwent baseline 18F-FDG PET/CT prior to treatment between March 2009 and January 2019 were enrolled in this retrospective study. The FDG-avid lesions in each patient were segmented using semiautomated software to calculate the maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG) values using the boundaries of voxels presenting with the 41% SUVmax threshold method. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate patient prognosis. The log-rank test and Cox regression analyses were used to evaluate PFS and OS.Results: ROC curve analysis indicated an ideal TMTV cut-off value of 228.8 cm3. During the 4-131 month (29.2±28.5 months) follow-up period, high TMTV was significantly associated with worse PFS and OS. TMTV and the international peripheral T-cell lymphoma project score (IPTCLP) were independent predictors of PFS and OS with multivariate analysis. The combination of TMTV and the IPTCLP may provide significantly better risk substratification in PFS and OS of PTCL patients.Conclusions: Both TMTV and IPTCLP are independent predictors of PTCL patient survival outcomes. Moreover, the combination of TMTV and IPTCLP improved patient risk stratification and may contribute to personalized therapeutic regimens.

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