Purpose In the present study, we aimed to investigate the role of baseline, interim and end-of treatment positron emission tomography/computed tomography (PET/CT) in assessing the prognosis of follicular lymphoma (FL). Methods A total of 84 FL patients were retrospectively analyzed in this study. Baseline (n=59), interim (n=24, after 2–4 cycles) and end-of treatment (n=43) PET/CT images were re-evaluated, and baseline maximum standardized uptake value (SUV max ), total metabolic tumor volume (tMTV) and total lesion glycolysis (TLG) were recorded. Interim (I-PET) and end-of treatment (E-PET) PET/CT responses were interpreted by Deauville five-point scale (D-5PS) and International Harmonization Project criteria (IHP). Survival curves were calculated by Kaplan-Meier curves, and differences between groups were compared by log-rank test. Results The 2-year progression-free survival (PFS) of the high- and low-TLG groups was 57.14% and 95.56%, respectively ( p =0.0001). The 2-year overall survival (OS) of the high- and low-TLG groups was 62.50% and 100%, respectively ( p <0.0001). Multivariate analysis showed that TLG was an independent prognostic factor for PFS ( p =0.001, HR=6.577, 95% CI=2.167–19.960) and OS ( p =0.030, HR=19.291, 95% CI =2.689–137.947). Besides, Eastern Cooperative Oncology Group (ECOG) was the independent prognostic factor for OS (HR=8.924, 95% CI=1.273–62.559, p =0.028). Interim PET results based on D-5PS or IHP criteria were not significantly correlated with PFS (all p >0.05). However, E-PET results using D-5PS and IHP criteria were statistically significant ( p =0.0001 and p =0.006). The D-5PS showed stronger prognostic value compared with IHP criteria. The optimal cutoff value of ΔSUV max % was 66.95% according to I-PET and 68.97% according to E-PET. However, only the ΔSUV max % from the baseline to the end-of therapy yielded statistically significant results in the prediction of PFS ( p =0.0002). Conclusion Our findings indicated that the baseline TLG and E-PET results were significantly associated with prognosis in patients with FL.

Purpose. In the present study, we aimed to investigate whether the radiomic features of baseline 18F-FDG PET can predict the prognosis of Hodgkin lymphoma (HL). Methods. A total 65 HL patients (training cohort: n = 49; validation cohort: n = 16) were retrospectively enrolled in the present study. A total of 47 radiomic features were extracted from pretreatment PET images. The least absolute shrinkage and selection operator (LASSO) regression was used to select the most useful prognostic features in the training cohort. The distance between the two lesions that were the furthest apart (Dmax) was recorded. The receiver operating characteristic (ROC) curve, Kaplan–Meier method, and Cox proportional hazards model were used to assess the prognostic factors. Results. Long-zone high gray-level emphasis extracted from a gray-level zone-length matrix (LZHGEGLZLM) (HR = 9.007; p = 0.044 ) and Dmax (HR = 3.641; p = 0.048 ) were independently correlated with 2-year progression-free survival (PFS). A prognostic stratification model was established based on both risk predictors, which could distinguish three risk categories for PFS ( p = 0.0002 ). The 2-year PFS was 100.0%, 64.7%, and 33.3%, respectively. Conclusions. LZHGEGLZLM and Dmax were independent prognostic factors for survival outcomes. Besides, we proposed a prognostic stratification model that could further improve the risk stratification of HL patients.

Copper-64 (T1/2 = 12.7 hours; β+: 19%, β−: 38%) has a unique decay profile and can be used for positron emission tomography imaging and radionuclide therapy. The well-established coordination chemistry of copper allows for its reaction with different types of chelator systems. It can be linked to antibodies, proteins, peptides, and other biologically relevant small molecules. Two potential ways to produce copper-64 radioisotopes concern the use of the cyclotron or the reactor. This review summarized several commonly used biomarkers of copper-64 radionuclide.

Introduction: In the present study, we aimed to investigate the prognostic value of metabolic parameters, including maximum standardized uptake value (SUV max ), total metabolic tumour volume (tMTV) and total lesion glycolysis (TLG), measured at baseline 18 F-FDG PET/CT in paediatric lymphoma. Methods: From March 2013 to April 2019, 47 patients with paediatric lymphoma, including 38 males and nine females with an average age of 14.87 years, who underwent 18 F-FDG PET/CT scan prior to treatment were retrospectively included in this study. SUV max , MTV and TLG were recorded. Survival curves were established according to the Kaplan-Meier curves and log-rank test. Mann-Whitney U-test was used to assess differences in metabolic parameters between different clinical outcomes. Results: The median follow-up time was 36 months (range of 3-74 months). The 2-year progression-free survival (PFS) of the low TLG and high TLG groups was 95.24% (20/21) and 57.69% (15/26), respectively (P = 0.004). TLG and tMTV were significantly higher in progression-free patients compared with the progression group. Univariate analysis showed that B symptoms (P = 0.014), effusion (P = 0.010), tMTV (P = 0.008) and TLG (P = 0.004) were the predictive factors for PFS. The tMTV (P = 0.005), TLG (P = 0.005) and effusion (P = 0.003) were associated with OS. Multivariate analysis revealed that TLG was the only independent prognostic factor for PFS (HR = 11.133, 95% CI = 1.435-86.405, P = 0.021). Conclusions: Collectively, TLG of baseline 18 F-FDG PET/CT was an independent prognostic factor for PFS in patients with paediatric lymphoma.

ObjectiveIn the present study, we aimed to evaluate the prognostic value of PET/CT-derived radiomic features for patients with B-cell lymphoma (BCL), who were treated with CD19/CD22 dual-targeted chimeric antigen receptor (CAR) T cells. Moreover, we explored the relationship between baseline radiomic features and the occurrence probability of cytokine release syndrome (CRS).MethodsA total of 24 BCL patients who received 18F-FDG PET/CT before CAR T-cell infusion were enrolled in the present study. Radiomic features from PET and CT images were extracted using LIFEx software, and the least absolute shrinkage and selection operator (LASSO) regression was used to select the most useful predictive features of progression-free survival (PFS) and overall survival (OS). Receiver operating characteristic curves, Cox proportional hazards model, and Kaplan-Meier curves were conducted to assess the potential prognostic value.ResultsContrast extracted from neighbourhood grey-level different matrix (NGLDM) was an independent predictor of PFS (HR = 15.16, p = 0.023). MYC and BCL2 double-expressor (DE) was of prognostic significance for PFS (HR = 7.02, p = 0.047) and OS (HR = 10.37, p = 0.041). The combination of NGLDM_ContrastPET and DE yielded three risk groups with zero (n = 7), one (n = 11), or two (n = 6) factors (p &lt; 0.0001 and p = 0.0004, for PFS and OS), respectively. The PFS was 85.7%, 63.6%, and 0%, respectively, and the OS was 100%, 90.9%, and 16.7%, respectively. Moreover, there was no significant association between PET/CT variables and CRS.ConclusionsIn conclusion, radiomic features extracted from baseline 18F-FDG PET/CT images in combination with genomic factors could predict the survival outcomes of BCL patients receiving CAR T-cell therapy.

Purpose. In the present study, we aimed to investigate whether the metabolic parameters on baseline 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) could be used to predict prognosis in peripheral T-cell lymphomas (PTCL). Methods. A total of 51 nodal PTCL patients who underwent baseline 18F-FDG PET/CT were retrospectively evaluated in the present study. Total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were also assessed. Besides, the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) was also included. Log-rank test and Cox regression analysis were used to evaluate progression-free survival (PFS) and overall survival (OS). Results. The median follow-up was 18 months. Patients with low TLG, TMTV, and SUVmax levels had a significantly better clinical outcome than those with high TLG, TMTV, and SUVmax levels. The 2-year PFS rates of the high- and low-TMTV groups were 34.62% and 80%, respectively (p<0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p<0.001). The 2-year PFS rates of the high- and low-TLG groups were 29.63% and 87.50%, respectively (p<0.001), whereas the corresponding 2-year OS rates were 40.74% and 91.67%, respectively (p<0.001). In multivariate analysis, TLG and TMTV were independent prognostic factors of both PFS (HR 11.562, 95% CI 3.218-41.542, p<0.001 and HR 7.061, 95% CI 2.464-20.229, p<0.001, respectively) and OS (HR 11.609, 95% CI 2.595-51.930, p=0.001 and HR 5.026, 95% CI 1.538-16.421, p=0.008, respectively). Moreover, SUVmax and NCCN-IPI scores were also independent predictors of OS (HR 3.161, 95% CI 1.197-8.346, p=0.020 and HR 3.112, 95% CI 1.109-8.732, p=0.031, in TMTV multivariate models). Combination of TMTV and NCCN-IPI scores stratified the patients into three risk groups for PFS (p=0.002) and OS (p<0.001) as follows: high-risk group with TMTV>62.405 cm3 and NCCN-IPI score of 4-8 (2-year PFS and OS were both 20%, n=10), intermediate-risk group with TMTV>62.405 or NCCN-IPI score of 4-8 (2-year PFS and OS were 52.4% and 66.7%, respectively, n=21), and low-risk group with TMTV≤62.405 cm3 and NCCN-IPI score of 0-3 (2-year PFS and OS were 80% and 85%, respectively, n=20). Conclusions. Baseline TMTV and TLG were independent predictors of PFS and OS in PTCL patients, and SUVmax and NCCN-IPI scores were also independent predictors of OS. Moreover, the combination of TMTV and NCCN-IPI scores improved patient risk-stratification at the initial stage and might contribute to the adjustment of the therapeutic regime. This trial is registered with ChiCTR1900025526.

We aimed at comparing the Durie–Salmon Plus (DS Plus) staging system based on Italian Myeloma criteria for PET USe (IMPeTUs) with other two staging systems in predicting prognosis of patients with all stages of newly diagnosed multiple myeloma (MM). A total of 33 MM patients were enrolled in this retrospective study. The variation between the DS Plus classification and Durie–Salmon staging system (DSS) or Revised International Staging System (RISS) classification was assessed. When staged by the DSS, patients in stage I and stage II did not reach the median overall survival (OS), and the median OS was 33 months for stage III (p=0.3621). When staged by the DS Plus, patients in stage I did not reach the median OS of stage I, and the median OS for stages II and III was 38 and nine months, respectively (p=0.0064). When staged by the RISS, patients in stage I did not reach the median OS, and the median OS was 33 and 16 months for stage II and stage III, respectively (p=0.0319). The concordances between two staging systems were 0.07 (DS Plus versus DSS) and 0.37 (DS Plus versus RISS), respectively. Multivariate analysis revealed that DS Plus stage III (HR: 11.539, p=0.021) and the Deauville score of bone marrow ≥4 (HR: 3.487, p=0.031) were independent prognostic factors associated with OS. Both the DS Plus based on IMPeTUs and RISS possessed a better potential in characterizing and stratifying MM patients compared with the DSS. Moreover, DS Plus stage III and the Deauville score of bone marrow ≥4 were reliable prognostic factors in newly diagnosed MM patients.

As a malignant hematopoietic stem cell disease, leukemia remains life-threatening due to its increasing incidence rate and mortality rate. Therefore, its early diagnosis and treatment play a very important role. In the present work, we systematically reviewed the current applications and future directions of positron emission tomography (PET) in patients with leukemia, especially 18F-FDG PET/CT. As a useful imaging approach, PET significantly contributes to the diagnosis and treatment of different types of leukemia, especially in the evaluation of extramedullary infiltration, monitoring of leukemia relapse, detection of Richter’s transformation (RT), and assessment of the inflammatory activity associated with acute graft versus host disease. Future investigations should be focused on the potential of PET/CT in the prediction of clinical outcomes in patients with leukemia and the utility of novel radiotracers.