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

Abstract

Purpose There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL.Materials and Methods Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test.Results The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001).Conclusion Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.

The Role of Pre-therapeutic 18F-FDG PET/CT in Pediatric Hemophagocytic Lymphohistiocytosis With Epstein-Barr Virus Infection

“…The baseline SUV max , TLG and MTV of lymph nodes were related to OS in lymphoma, including HL, diffuse Large B-cell lymphoma, follicular lymphoma, peripheral T lymphocyte lymphoma, extranodal NK/T lymphoma, etc. (11,40). Besides, elevated IL-6 indicates strong "inflammatory storm, " suggesting the internal environment disturbance and a high mortality rate.…”

“…18 F-FDG PET/CT is a whole-body scan widely used in many diseases, such as infection, malignant disease, and rheumatic immunity disease (10). In varieties of lymphoma, it is used in differential diagnosis, treatment decision, response evaluation and prognosis prediction (10,11). 18 F-FDG PET/CT is better than conventional radiography, as it can display the extranodal lesions better and measure the metabolism in semi-quantitative analysis (12).…”

Prognostic Value of Heterogeneity Index Derived from Baseline 18F-FDG PET/CT in Mantle Cell Lymphoma

“…Feng et al. indicated that baseline SUV max measured on 18 F-FDG in T-cell lymphoblastic lymphoma was significantly related to PFS and OS ( 35 ). Okuyucu et al.…”

Prognostic significance of clinical characteristics and 18Fluorodeoxyglucose-positron emission tomography/computed tomography quantitative parameters in patients with primary mediastinal B-cell lymphoma

“…7 It also has value in predicting diagnosis, evaluating treatment response, and providing prognostic information for lymphoma and other solid tumors. 8 – 11 To date, the quantitative parameters of 18 FDG-PET/CT have been investigated in several lymphoma entities, including PMBCL, illustrating its prognostic value. 12 – 14 …”

“…7 It also has value in predicting diagnosis, evaluating treatment response, and providing prognostic information for lymphoma and other solid tumors. [8][9][10][11] To date, the quantitative parameters of 18 FDG-PET/CT have been investigated in several lymphoma entities, including PMBCL, illustrating its prognostic value. [12][13][14] In the current study, we retrospectively reviewed a cohort of patients with PMBCL to provide insights into treatment modalities and the prognostic utility of certain clinical characteristics, as well as clarify the features of 18 FDG-PET/CT.…”