Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in Burkitt lymphoma

Albano, Domenico; Bosio, Giovanni; Pagani, Chiara; Re, Alessandro; Tucci, Alessandra; Giubbini, Raffaele; Bertagna, Francesco

doi:10.1007/s00259-018-4173-2

Cited by 65 publications

(50 citation statements)

References 38 publications

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“…However, in our study, Cox's proportional hazards models indicated that SUV TBR was not an independent prognostic factor for OS, despite a significantly longer OS in patients with lower SUV TBR in the univariate analysis. This result is highly in agreement with the previous findings by Albano et al (43,44). One possible explanation is that, due to the anatomical structure, the SUVmax of the blood pool may be influenced by the primary esophageal tumor and mediastinal metastatic lymph nodes.…”

Section: Discussionsupporting

confidence: 93%

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: Discussionsupporting

confidence: 93%

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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“…Previous clinicopathological studies demonstrated that PD-L1 expression level within tumor cells was closely correlated with 18 F-FDG uptake 10 – 12 ; therefore, the accumulation of 18 F-FDG may be expected to predict the efficacy of anti-PD-1 antibody, similar to the role of PD-L1 expression as a predictive marker. In patients with Burkitt’s lymphoma as an aggressive lymphoma, it has reported that metabolic tumor volumes determined by MTV and TLG significantly correlated with response to treatment and long-term survival compared to SUV max 21 . Also, Albano et al reported that MTV and TLG were closely associated with therapeutic response and PFS in patients with mantle cell lymphoma 22 .…”

Section: Discussionmentioning

confidence: 99%

Tumor metabolic volume by 18F-FDG-PET as a prognostic predictor of first-line pembrolizumab for NSCLC patients with PD-L1 ≥ 50%

Yamaguchi

Kaira

Hashimoto

et al. 2020

Sci Rep

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There is a lack of markers for predicting favorable outcomes after pembrolizumab therapy in patients with non-small cell lung cancer (NSCLC) with programmed death ligand-1 (PD-L1) expression ≥ 50%. This retrospective study examined the prognostic significance of 2-deoxy-2-[18F] fluoro-d-glucose (18F-FDG) uptake as a predictive marker of first-line pembrolizumab. Forty-eight patients with previously untreated NSCLC and PD-L1 expression levels ≥ 50% who underwent 18F-FDG-positron emission tomography (PET) just before administration of pembrolizumab monotherapy were eligible and underwent assessment of metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum of standardized uptake value (SUVmax) on 18F-FDG uptake. The objective response rate, median progression-free survival, and median overall survival were 51.1%, 7.1 months, and 18.6 months, respectively. In univariate survival analyses, high MTV was barely a significant prognostic predictor and was confirmed as an independent factor linked to worse outcomes in multivariate analysis, predominantly in patients with a histological diagnosis of adenocarcinoma. A high MTV was significantly associated with distant metastases (especially bone metastasis), C-reactive protein (CRP) level, and PD-L1 expression ≥ 75%. Metabolic tumor activity assessed as MTV from 18F-FDG uptake predicted the prognosis after first-line pembrolizumab treatment in patients with NSCLC and PD-L1 expression ≥ 50%, especially for adenocarcinoma.

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“…These so-called second-order metrics, also based on the SUV concept, are very interesting as they-in contrast to first order metrics as SUV max or SUV peak -try to capture the metabolic information from the entire tumour volume. And indeed, several studies report very promising results regarding the prognostic value of these parameters for various lymphoma types [30,31] as well as for soft tissue and bone sarcoma [16,32]. However, studies comparing the value of MTV and TLG with simple SUV max and SUV peak metrics as used in the current work do not show a clear advantage of the second-order methods in these tumour types [33][34][35].…”

Section: Discussionmentioning

confidence: 66%

What and how should we measure in paediatric oncology FDG-PET/CT? Comparison of commonly used SUV metrics for differentiation between paediatric tumours

et al. 2019

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Background: In clinical routine, SUV max and SUV peak are most often used to determine the glucose metabolism in tumours by 18 F-FDG PET/CT. Both metrics can be further normalised to SUVs in reference regions resulting in a SUV ratio (SUV ratio ). The aim of the study was to directly compare several widely used SUVs/SUV ratios with regard to differentiation between common tumours in paediatric patients; a special focus was put on characteristics of reference region SUVs.Methods: The final study population consisted of 61 children and adolescents with diagnoses of non-Hodgkin lymphoma (NHL, n = 25), Hodgkin lymphoma (HL, n = 14), and sarcoma (n = 22). SUV metrics included SUV max and SUV peak as well as both parameters normalised to liver and mediastinal blood pool, respectively, yielding the SUV ratios SUV max/liver , SUV max/mediastinum , SUV peak/liver , and SUV peak/mediastinum . Results: The metrics SUV max , SUV peak , SUV max/liver , and SUV peak/liver all proved to be sensitive for tumour differentiation (p ≤ 0.008); in contrast, SUV max/mediastinum and SUV peak/mediastinum revealed to be non-sensitive approaches. Correlation analyses showed inverse associations between reference region SUVs and SUV ratios (p < 0.05). Multiple regression analyses demonstrated significant effects of factors as bodyweight and uptake time on reference region SUVs (p < 0.01), and thus indirectly on the corresponding SUV ratios . Conclusions: In the paediatric population, the ability to differentiate between common tumours remarkably varies between SUV metrics. When using SUV ratios , the choice of reference region is crucial. Factors potentially influencing reference region SUVs (and thus SUV ratios ) should be taken into account in order to avoid erroneous conclusions. When not possible, SUV max and SUV peak represent less complex, more robust alternatives.

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Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in Burkitt lymphoma

Cited by 65 publications

References 38 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

Tumor metabolic volume by 18F-FDG-PET as a prognostic predictor of first-line pembrolizumab for NSCLC patients with PD-L1 ≥ 50%

What and how should we measure in paediatric oncology FDG-PET/CT? Comparison of commonly used SUV metrics for differentiation between paediatric tumours

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