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Early interim PET/CT predicts post-treatment response in diffuse large B-cell lymphoma
Xingchen Wu1, Hannu Pertovaara, Pasi Korkola
1Department of Oncology, Tampere University Hospital , Tampere , Finland.
Acta Oncologica (Stockholm, Sweden)
|June 25, 2014
Summary
Maximal standardized uptake value (SUVmax) on baseline PET/CT better predicts tumor aggressiveness in diffuse large B-cell lymphoma (DLBCL) than biopsy. Interim PET/CT one week after R-CHOP therapy can guide risk stratification.
Area of Science:
- Nuclear Medicine
- Oncology
- Radiology
Background:
- (18)F-FDG-PET/CT is crucial for staging and response assessment in malignant lymphomas.
- Maximal standardized uptake value (SUVmax) is a key PET parameter.
- Metabolic tumor burden (MTB) integrates tumor volume (MTV) and activity.
Purpose of the Study:
- To analyze the prognostic value of SUVmax, SUVsum, MTVwb, and MTBwb.
- To evaluate baseline and interim PET/CT parameters in diffuse large B-cell lymphoma (DLBCL).
- To compare SUVmax accuracy with biopsy for tumor aggressiveness.
Main Methods:
- Twenty-nine DLBCL patients underwent PET/CT before and one week after R-CHOP therapy.
- Biopsy specimens were analyzed for Ki-67 proliferation index (PI).
- Response was evaluated after 6-8 cycles of chemotherapy.
Main Results:
- Whole-body SUVmax (BmSUVmax) was higher than biopsy site SUVmax (BxSUVmax) (p < 0.01).
- PI correlated with BxSUVmax (p < 0.05).
- Interim PET/CT parameters (SUVsum, MTVwb, MTBwb) significantly decreased and correlated with treatment response (p < 0.05).
Conclusions:
- BmSUVmax is more accurate for detecting DLBCL aggressiveness than biopsy.
- Interim PET/CT after one R-CHOP dose predicts treatment response.
- Interim PET/CT can guide risk stratification in DLBCL.
