Baseline Total Metabolic Tumor Volume and Total Lesion Glycolysis Measured on <sup>18</sup>F-FDG PET-CT Predict Outcomes in T-Cell Lymphoblastic Lymphoma

Background:Recently, there are many reports from Japan about methotrexate associated lymphoproliferative disorder (MTX-LPD). We are investigating the predictive factor of spontaneous regression (SR) in MTX-LPD. On the other hand, FDG-PET/CT is used for diagnosis of LPD including malignant lymphoma. In addition, it was reported that imaging biomarkers such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) could predict the prognosis of malignant tumor (1, 2). However, there is no report that these imaging biomarkers could predict the SR of MTX-LPD.Objectives:We investigate the usefulness of FDG-PET/CT for predictive factor of SR in MTX-LPD.Methods:We enrolled 24 RA patients who diagnosed MTX-LPD and performed FDG-PET/CT from 2005 to 2019. We divided these cases into spontaneous regression cases (SR group; 15 cases) and cases that treated with chemotherapy after MTX discontinuation (CTx group; 9 cases), and compared the difference as follow subjects between two groups; clinical data including histopathological findings, SUVmax to evaluate malignant tumor activity by FDG-PET/CT, MTV and TLG which refer to metabolically active volume of the tumor segmented FDG-PET/CT. In addition, we analyzed cut off levels, sensitivity and specificity using statistical software JMP.Results:Diffuse large B cell lymphoma (DLBCL) and Hodgkin lymphoma (HL) were 5 and 1 cases in SR group, and 1 and 5 cases in CTx group. In addition, MTV and TLG by FDG-PET/CT was significantly lower in SR group, although SUVmax is no difference between two groups (figure 1). Cut off levels of MTV and TLG were 103.12 ml (sensitivity; 88.9%, specificity; 86.7%) and 361.75 ml (sensitivity; 88.9%, specificity; 86.7%), respectively.Conclusion:We suggested that MTV and TLG were useful for predict of SR in MTX-LPD.References:[1]Chen HH, Chiu NT, Su WC. et al. Prognostic value of whole-body total lesion glycolysis at pretreatment FDG PET/CT in non-small cell lung cancer. Radiology. 2012 Aug;264(2):559-66.[2]Chu KP, Murphy JD, La TH. et al. Prognostic value of metabolic tumor volume and velocity in predicting head-and-neck cancer outcomes. Int J Radiat Oncol Biol Phys. 2012 Aug 1;83(5):1521-7.Figure 1.Comparison of the level of MTV(a) and TLG (b).Disclosure of Interests:None declared

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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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