Baseline and ongoing PET-derived factors predict detrimental effect or potential utility of 18F-FDG PET/CT (FDG-PET/CT) performed for surveillance in asymptomatic lymphoma patients in first remission

Morbelli, Silvia; Capitanio, Selene; Carli, Fabrizio De; Bongioanni, Francesca; Astis, Enrico De; Miglino, Maurizio; Verardi, Maria Teresa; Buschiazzo, Ambra; Fiz, Francesco; Marini, Cecilia; Pomposelli, Elena; Sambuceti, Gianmario

doi:10.1007/s00259-015-3164-9

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…For all 18 F-FDG PET/CT scans, the following 8 parameters were measured: maximum diameter of the primary lesion (T); maximum diameter of the largest lymph node (N); maximum diameter of the largest metastatic lesion (M); SUV max ; SUV mean ; size-incorporated SUV max (SIMaxSUV); MTV; and TLG. SUV max , SUV mean , SIMaxSUV, MTV, and average glycolytic volume were independently measured for T, N, and M. In particular, SIMaxSUV was defined as the product of the largest diameter (mm) of the primary lesion (for T) or of the largest lesion (for N and M) and the SUV max of the same lesion (16,17); MTV was assessed using a syngo (Siemens) workstation and was computed using an SUV max of greater than or equal to 2.5 as a threshold (10); and TLG for T, N, and M was computed as MTV • SUV mean .…”

Section: Image Analysismentioning

confidence: 99%

Circulating Tumor DNA Reflects Tumor Metabolism Rather Than Tumor Burden in Chemotherapy-Naive Patients with Advanced Non–Small Cell Lung Cancer: ¹⁸F-FDG PET/CT Study

et al. 2017

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We aimed to evaluate the relationships between circulating tumor cells (CTCs) or plasma cell-free DNA (cfDNA) on one side and a comprehensive range of F-FDG PET/CT-derived parameters on the other side in chemotherapy-naive patients with advanced non-small cell lung cancer (NSCLC). From a group of 79 patients included in a trial evaluating the role of pretreatment circulating tumor markers as predictors of prognosis in chemotherapy-naive patients with advanced NSCLC, we recruited all those who underwent F-FDG PET/CT for clinical reasons at our institution before inclusion in the trial (and thus just before chemotherapy). For each patient, a peripheral blood sample was collected at baseline for the evaluation of CTCs and cfDNA. CTCs were isolated by size using a filtration-based device and then morphologically identified and enumerated; cfDNA was isolated from plasma and quantified by a quantitative polymerase chain reaction using human telomerase reverse transcriptase. The followingF-FDG PET/CT-derived parameters were computed: maximum diameter of the primary lesion (T), of the largest lymph node (N), and of the largest metastatic lesion (M); SUV; SUV; size-incorporated SUV; metabolic tumor volume; and total lesion glycolysis. All parameters were independently measured for T, N, and M. The associations among CTCs, cfDNA, and F-FDG PET/CT-derived parameters were evaluated by multivariate-analysis. Patients were divided into 2 groups according to the presence of either limited metastatic involvement (M1a or M1b due to extrathoracic lymph nodes only) or disseminated metastatic disease. The presence or absence of metabolically active bone lesions was also recorded for each patient, and patient subgroups were compared. Thirty-seven patients recruited in the trial matched our PET-based criteria (24 men; age, 64.5 ± 8.1 y). SUV for the largest metastatic lesion was the only variable independently associated with baseline cfDNA levels ( = 0.016). Higher levels of cfDNA were detected in the subgroup of patients with metabolically active bone lesions ( = 0.02), but no difference was highlighted when patients with more limited metastatic disease were compared with patients with disseminated metastatic disease. The correlation of cfDNA levels with tumor metabolism, but not with metabolic tumor volume at regional or distant levels, suggests that cfDNA may better reflect tumor biologic behavior or aggressiveness rather than tumor burden in metastatic NSCLC.

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Section: Image Analysismentioning

confidence: 99%

Circulating Tumor DNA Reflects Tumor Metabolism Rather Than Tumor Burden in Chemotherapy-Naive Patients with Advanced Non–Small Cell Lung Cancer: ¹⁸F-FDG PET/CT Study

et al. 2017

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“…19,20 Investigators examined the size-incorporated maximum standardized uptake value (SIMaxSUV), defined as the product of SUVmax and the greatest lesion diameter, and found that a high SIMaxSUV is the single most important predictor for disease-free survival and overall survival in DLBCL patients. 33 In the present study, ΔSUVmax*ΔSLD is defined as the change in the product of ΔSLD and ΔSUVmax, which is similar to the change in SIMaxSUV. ΔSLD is easily measured and reproducible.…”

Section: Discussionmentioning

confidence: 97%

Interim PET/CT based on visual and semiquantitative analysis predicts survival in patients with diffuse large B‐cell lymphoma

Sun

et al. 2019

Cancer Medicine

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Purpose The role of interim 18 F‐FDG PET/CT (iPET/CT) in diffuse large B‐cell lymphoma (DLBCL) remains controversial. The purpose of this study was to assess the prognostic value of iPET/CT in patients with newly diagnosed DLBCL according to visual and semiquantitative interpretation methods. Methods A total of 129 newly diagnosed DLBCL patients with baseline PET/CT data were retrospectively screened. The iPET/CT findings were evaluated by the Deauville 5‐point scale (DS) and ΔSUVmax. Furthermore, the reduction in SUVmax incorporated with tumor size (ΔSUVmax*ΔSLD) was calculated. The optimal cutoff values of ΔSUVmax and ΔSUVmax*ΔSLD were determined by receiver operating characteristic (ROC) analysis. Kaplan‐Meier analysis was applied to test for the influence of prognostic values. Univariate and multivariate analyses were conducted to examine the potential independent impacts of iPET/CT. Results Seventy‐seven patients with PET/CT images acquired both at baseline and after four cycles of chemotherapy were finally enrolled. The optimal cutoff values for ΔSUVmax and ΔSUVmax*ΔSLD were 74% and 30%, respectively. After a median follow‐up of 23 months, iPET/CT findings were significant predictors of PFS and OS whenever iPET/CT was interpreted by DS, ΔSUVmax, or ΔSUVmax*ΔSLD methods. ΔSUVmax‐based methods were more accurate than those based on DS. The IPI, DS, ΔSUVmax, and ΔSUVmax*ΔSLD were predictive in univariate analyses. However, in the multivariate analysis, only IPI and ΔSUVmax remained independent predictors of PFS and OS. Conclusions Interim PET/CT may help to identify DLBCL patients with different prognoses. ΔSUVmax analysis shows the best accuracy and the strongest predictive value among these three methods. ΔSUVmax*ΔSLD may be a promising parameter to interpret iPET/CT images, reflecting both the changes in tumor size and metabolic activity.

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“…Early identi cation of patients with DLBCL who are rapidly progressing under conventional therapy is needed to aid strati cation for innovative treatment. This requires an more adapted risk scoring method in which imaging features and genetic factors could play an important role together, according to recent research progress [1,11,14,25] . The current study is believed to be the rst to evaluate the relevance of combination of TMTV and SDmax calculated from the initial PET/CT ndings and genetic mutations obtained by NGS.…”

Section: Discussionmentioning

confidence: 99%

“…The 43 genes designed in a panel based on literature review of NGS studies in DLBCL [22][23][24][25] were as follows: ARID1B, ATM, B2M, BCL10, BCL2, BCL6, BTG1, CARD11, CCND3, CD58, CD79A, CD79B, CDKN2A, CIITA, CREBBP, EPHA7, EZH2, EP300, FAS, GNA13, IRF8, ITPKB, JAK2, KMT2C, KMT2D, MEF2B, MFHAS1, MYC, MYD88, NOTCH1, NOTCH2, PAX5, PIM1, PPM1D, SOCS1, SGK1, STAT3, STAT6, TET2, TNFAIP3, TNFRSF14, TP53, and XPO1. The lymphopanel was designed by KingMed.…”

Section: Ngs Data Analysismentioning

confidence: 99%

Combination of baseline PET/CT total metabolic tumor volume, lesion dissemination and TP53 mutations predicts rapid progression of diffuse large B-cell lymphoma

Liu¹,

Shi²,

Li³

et al. 2022

Preprint

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Background: The existing International Prognostic Index (IPI) scoring system has failed to fully identify high risk population for diffuse large B-cell lymphoma (DLBCL). The next-generation prognosis model may combine PET scanning indicators, total metabolic tumor volume (TMTV) or the largest distance between 2 lesions (Dmax) normalized with the body surface area [standardized Dmax (SDmax)], and genetic mutations to identify high-risk patients early. Methods: We analyzed 93 patients with DLBCL treated with rituximab and CHOP/CHOP-like regimen. TMTV was calculated using the 41% maximum standardized uptake value thresholding method. From the 3D coordinates, the centroid of each lesion was automatically obtained and considered as the lesion location; Dmax was calculated and normalized by patient body surface area (BSA), given by √(weight x height)36 00, yielding SDmax. The pathological tissues of all patients before treatment were sequenced by a lymphopanel to identify mutations in 43 genes. Results: The optimal TMTV cutoff was 210.1 cm3, and the optimal SDmax cutoff was 0.146 m-1. In multivariate analysis, high SDmax, high TMTV and A53-like subtype were independent prognostic factors of PFS (P=0.047, 0.035 and 0.031, respectively). TMTV or SDmax combined with TP53 mutations can identify significant risk stratification in patients. TMTV combined with TP53 mutations identified 3 groups with a significant difference in PFS (P=0.003): 42 patients with low TMTV regardless of TP53 status; 36 with high TMTV and wild-type TP53; and 15 with high TMTV and mutant TP53. In the three groups, 1-year PFS was 81.4%, 55.4% and 38.9%, respectively. SDmax combined with TP53 mutations also identified 3 groups with a significant difference in PFS (P < 0.001), and 1-year PFS was 84.8%, 58.3% and 32.0%, respectively. Conclusions: In patients with low tumor burden or without distant metastasis, gene mutations seems to have little effect on prognosis. While in patients with heavy load, combination of TMTV or SDmax with TP53 mutations could lead to more accurate selection and better individualized treatment. Based on this study, we suggest that next-generation sequencing should be carried out in the newly diagnosed patients with heavy tumor load or distant metastasis in the future, so as to further distinguish the high-risk patients and guide the treatment.

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Baseline and ongoing PET-derived factors predict detrimental effect or potential utility of 18F-FDG PET/CT (FDG-PET/CT) performed for surveillance in asymptomatic lymphoma patients in first remission

Cited by 10 publications

References 29 publications

Circulating Tumor DNA Reflects Tumor Metabolism Rather Than Tumor Burden in Chemotherapy-Naive Patients with Advanced Non–Small Cell Lung Cancer: ¹⁸F-FDG PET/CT Study

Circulating Tumor DNA Reflects Tumor Metabolism Rather Than Tumor Burden in Chemotherapy-Naive Patients with Advanced Non–Small Cell Lung Cancer: ¹⁸F-FDG PET/CT Study

Interim PET/CT based on visual and semiquantitative analysis predicts survival in patients with diffuse large B‐cell lymphoma

Combination of baseline PET/CT total metabolic tumor volume, lesion dissemination and TP53 mutations predicts rapid progression of diffuse large B-cell lymphoma

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Baseline and ongoing PET-derived factors predict detrimental effect or potential utility of 18F-FDG PET/CT (FDG-PET/CT) performed for surveillance in asymptomatic lymphoma patients in first remission

Cited by 10 publications

References 29 publications

Circulating Tumor DNA Reflects Tumor Metabolism Rather Than Tumor Burden in Chemotherapy-Naive Patients with Advanced Non–Small Cell Lung Cancer: 18F-FDG PET/CT Study

Circulating Tumor DNA Reflects Tumor Metabolism Rather Than Tumor Burden in Chemotherapy-Naive Patients with Advanced Non–Small Cell Lung Cancer: 18F-FDG PET/CT Study

Interim PET/CT based on visual and semiquantitative analysis predicts survival in patients with diffuse large B‐cell lymphoma

Combination of baseline PET/CT total metabolic tumor volume, lesion dissemination and TP53 mutations predicts rapid progression of diffuse large B-cell lymphoma

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Circulating Tumor DNA Reflects Tumor Metabolism Rather Than Tumor Burden in Chemotherapy-Naive Patients with Advanced Non–Small Cell Lung Cancer: ¹⁸F-FDG PET/CT Study

Circulating Tumor DNA Reflects Tumor Metabolism Rather Than Tumor Burden in Chemotherapy-Naive Patients with Advanced Non–Small Cell Lung Cancer: ¹⁸F-FDG PET/CT Study