The Utility of Metabolic Parameters on Baseline F-18 FDG PET/CT in Predicting Treatment Response and Survival in Paediatric and Adolescent Hodgkin Lymphoma

Abstract

Lymphoma is the third most common paediatric cancer. Early detection of high-risk patients is necessary to anticipate those who require intensive therapy and follow-up. Current literature shows that residual tumor avidity on PET (Positron Emission Tomography) following chemotherapy corresponds with decreased survival. However, the value of metabolic parameters has not been adequately investigated. In this retrospective study, we aimed to evaluate the prognostic value of metabolic and other parameters in paediatric and adolescent Hodgkin lymphoma. We recorded tMTV (total Metabolic Tumor Volume), TLG (Total Lesion Glycolysis), and SUVmax (maximum Standard Uptake Value) on baseline PET, as well the presence of bone marrow or visceral involvement. HIV (human immunodeficiency virus) status and baseline biochemistry from clinical records were noted. All patients received stage-specific standard of care therapy. Response assessment on end-of-treatment PET was evaluated according to the Deauville criteria. We found that bone marrow involvement (p = 0.028), effusion (p < 0.001), and treatment response (p < 0.001) on baseline PET, as well as HIV status (p = 0.036) and baseline haemoglobin (p = 0.039), were significantly related to progression-free survival (PFS), whereas only effusion (p = 0.017) and treatment response (p = 0.050) were predictive of overall survival (OS). Only baseline tMTV predicted treatment response (p = 0.017). This confirms the value of F-18 FDG PET/CT (Fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography) in prognostication in paediatric and adolescent Hodgkin lymphoma; however, further studies are required to define the significance of metabolic parameters.

[18F]FDG PET radiomics score generated by cross-combination approach for treatment response and prognosis prediction in primary gastrointestinal diffuse large B-cell lymphoma patients

“…Previous studies have indicated that PET volumetric parameters re ecting tumor metabolic burden, such as TMTV and TLG, may provide additional information as prognostic biomarkers for DLBCL [28,29]. Several retrospective studies have analyzed baseline PET metabolic parameters in HL patients, demonstrating that MTV or TLG are robust predictors of treatment response after chemotherapy [30,31]. Parvez et al [32] conducted a retrospective analysis of 82 NHL patients who underwent PET/CT and found that metabolic tumor parameters from [18F] FDG PET/CT could predict treatment response in NHL.…”

Recent advancements in 18F-FDG PET/CT for the diagnosis, staging, and treatment management of HIV-related lymphoma

“…A retrospective investigation conducted on children diagnosed with HIV-related lymphoma found the same findings. According to Reed et al's study [34], HIV infection level as well as therapy response on PET were significant independent predictors of PFS (P = 0.036 and P = 0.001, respectively). Conversely, no metabolic characteristic was predictive of overall survival (OS) or PFS.…”

Clinical value of 18F-FDG PET/CT in the management of HIV-associated lymphoma

“…In contrast, none of the metabolic parameters was significantly predictive of either PFS or overall survival (OS). Unlike in the adult research, the baseline total MTV was considered as a significant predictor of treatment response (p=0.017) ( 55 ).…”