Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in elderly HL: a two-center experience in 123 patients

Albano, Domenico; Mazzoletti, Angelica; Spallino, Marianna; Muzi, Cristina; Zilioli, V. R.; Pagani, Chiara; Tucci, Alessandra; Rossetti, Claudio; Giubbini, Raffaele; Bertagna, Francesco

doi:10.1007/s00277-020-04039-w

Cited by 34 publications

(45 citation statements)

References 27 publications

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“…The calibration method and care of how this calibration is performed will affect the basic quantitative accuracy of PET scanner (17). Many recent studies have suggested that standardization of semiquantitative measurement may be superior to SUVmax in the prediction of treatment response and prognosis (22,23). Standardization in its most common form is a ratio of FDG uptake in tumors to that in normal background tissue, such as the liver and mediastinal blood pool (24)(25)(26)(27)(28).…”

Section: Introductionmentioning

confidence: 99%

The PET-Derived Tumor-to-Liver Standard Uptake Ratio (SUVTLR) Is Superior to Tumor SUVmax in Predicting Tumor Response and Survival After Chemoradiotherapy in Patients With Locally Advanced Esophageal Cancer

Wang

Zhao

et al. 2020

Front. Oncol.

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Background: The maximum standardized uptake values (SUVmax) derived from 18 F-fluorodeoxy-glucose positron emission tomography/computed tomography (18 F-FDG PET/CT) have some well-known shortcomings in predicting treatment response and prognosis in oncology. The standardized SUVmax with an appropriate reference background may overcome this problem in some instances. This study explored the prognostic value of the tumor-to-liver SUVmax ratio (SUV TLR) and the tumor-to-blood pool SUVmax ratio (SUV TBR) in predicting the objective response (OR) and overall survival (OS) in patients with locally advanced esophageal cancer after concurrent chemoradiotherapy (CCRT). Methods: We retrospectively analyzed 128 newly diagnosed esophageal squamous cell carcinoma (ESCC) patients who were treated with CCRT. The SUVmax of primary tumor, SUV TLR , SUV TBR and clinicopathologic features data were analyzed. Univariate and multivariate analyses were used to determine the predictors of tumor response. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards model. Results: Receiver operating characteristic (ROC) curve analysis demonstrated that SUV TLR was superior to SUVmax and SUV TBR in predicting treatment response. Univariate and multivariate analyses revealed that advanced tumor stage (hazard ratio [HR] = 9.67; 95% CI: 1.15-81.28; P = 0.037) and high SUV TLR (HR = 21.92; 95% CI: 2.26-212.96; P = 0.008) were independent predictors of poor treatment response. Cox regression analysis showed that good clinical tumor response (p < 0.014, HR =0.501; 95% CI: 0.288-0.871) was a favorable independent predictive factor for OS, while an advanced tumor stage (p = 0.018, HR = 1.796; 95% CI: 1.107-2.915) and a high SUV TLR Wang et al. SUVTLR Survival Chemoradiotherapy Esophageal Cancer (p < 0.002, HR = 2.660; 95% CI: 1.425-4.967) were prognostic factors for poor OS. The median OS of patients in the low SUV TLR and high SUV TLR groups was 13.47 vs. 19.30 months, respectively. Conclusions: PET-derived SUV TLR is superior to tumor SUVmax and SUV TBR in predicting treatment response and overall survival in patients with ESCC undergoing CCRT. High SUV TLR was an independent predictor of poor treatment response and shorter overall survival.

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Section: Introductionmentioning

confidence: 99%

The PET-Derived Tumor-to-Liver Standard Uptake Ratio (SUVTLR) Is Superior to Tumor SUVmax in Predicting Tumor Response and Survival After Chemoradiotherapy in Patients With Locally Advanced Esophageal Cancer

Wang

Zhao

et al. 2020

Front. Oncol.

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“…The white blood cell count at diagnosis was >20×10 9 /l in 27 patients. The lactate dehydrogenase levels (>245 U/L) were high in 42 patients ( 19 ). Detailed characteristics of patients are presented in Table I .…”

Section: Resultsmentioning

confidence: 98%

“…Since not all extramedullary sites are easily detectable, EMD may have been under-diagnosed. 18 F-FDG PET/CT is a sensitive imaging modality for diagnosing EMD in AL ( 7 , 19 ). Kumar et al ( 41 ) compared 18 F-FDG PET/CT and CT in terms of response and prognosis of patients with AML with EMD and found that PET/CT can identify more lesions and cases of metabolically progressive disease compared with CT alone, thus affecting management.…”

Section: Discussionmentioning

confidence: 99%

The value of <sup>18</sup>F‑FDG PET/CT in the prediction of clinical outcomes of patients with acute leukemia treated with allogeneic hematopoietic stem cell transplantation

et al. 2020

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“…However, despite several positive results of SUV as prognostic factor in primary gastric DLBCL [ 16 ], SUV is for definition characterized by some factors that may affect their accuracy, like the uptake time between injection and imaging scan, the partial volume effect in case of small lesion, the risk of extravasation of administered radiotracer at the site of injection, the residual activity lost in the syringe, the decay of the injected activity and the technological features of the scanner, and acquisition and reconstruction parameters [ 17 ]. More recently, some variables indirectly expressing the volume-based metabolic disease, have emerged and seem to have a positive role in the evaluation of treatment response and outcome in different lymphoma [ 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. These parameters are MTV and TLG; additionally, in primary gastric DLBCL, some findings are available [ 11 , 12 , 13 , 14 ], but shared consensus is lacking.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Impact of Pretreatment 2-[18F]-FDG PET/CT Parameters in Primary Gastric DLBCL

et al. 2021

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Background and Objectives: Primary gastric diffuse large-B cell lymphoma (DLBCL) is an aggressive lymphoma subtype with high 18F-FDG avidity but unclear criteria for 2-[18F]-FDG PET/CT in the evaluation of treatment response and prognostication. Our aim was to investigate whether the pretreatment 2-[18F]-FDG PET/CT variables may predict treatment response (at end of first-line therapy) and prognosis in primary gastric DLBCL. Materials and Methods: we included 57 patients with a diagnosis of primary gastric DLBCL and a baseline 2-[18F]-FDG PET/CT and an end of treatment PET/CT after 6 cycles of R-CHOP chemotherapy. We analyzed PET images qualitatively and semi-quantitatively by deriving the maximum standardized uptake value body weight (SUVbw), the maximum standardized uptake value lean body mass (SUVlbm), the maximum standardized uptake value body surface area (SUVbsa), lesion to liver SUVmax ratio (L-L SUV R), lesion to blood-pool SUVmax ratio (L-BP SUV R), metabolic tumor volume and total lesion glycolysis of gastric lesion (gMTV and gTLG), and total MTV (tMTV) and TLG. Survival curves were plotted according to the Kaplan–Meier analysis. Results: at a median follow up of 80 months, the median PFS and OS were 69 and 80 months. Baseline gMTV, gTLG, tMTV, and TLG were significantly higher in patients with incomplete response (partial response and progression) compared to complete response group. tMTV and TLG were confirmed to be independent prognostic factors both for PFS (p = 0.023 and p = 0.038) and OS (p = 0.038 and p = 0.026); instead, the other metabolic parameters were not related to outcome survival. Conclusions: high tMTV and TLG were significantly correlated with shorter survival (PFS and OS) and may predict incomplete response after therapy.

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Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in elderly HL: a two-center experience in 123 patients

Cited by 34 publications

References 27 publications

The PET-Derived Tumor-to-Liver Standard Uptake Ratio (SUVTLR) Is Superior to Tumor SUVmax in Predicting Tumor Response and Survival After Chemoradiotherapy in Patients With Locally Advanced Esophageal Cancer

The PET-Derived Tumor-to-Liver Standard Uptake Ratio (SUVTLR) Is Superior to Tumor SUVmax in Predicting Tumor Response and Survival After Chemoradiotherapy in Patients With Locally Advanced Esophageal Cancer

The value of <sup>18</sup>F‑FDG PET/CT in the prediction of clinical outcomes of patients with acute leukemia treated with allogeneic hematopoietic stem cell transplantation

Prognostic Impact of Pretreatment 2-[18F]-FDG PET/CT Parameters in Primary Gastric DLBCL

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