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Baseline Total Metabolic Tumor Volume Measured with Fixed or Different Adaptive Thresholding Methods Equally Predicts
Anne-Ségolène Cottereau1, Sebastien Hapdey2,3, Loic Chartier4
1Nuclear Medicine Department, Hôpital Henri Mondor, University Paris-Est Créteil, Créteil, France annesegolene.cottereau@aphp.fr.
Summary
Total metabolic tumor volume (TMTV) measured by adaptive thresholding methods or a fixed 41% SUVmax threshold are strong predictors of outcome in peripheral T cell lymphoma. These TMTV measurements demonstrated similar prognostic value for patient survival.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiomics
Background:
- Peripheral T cell lymphoma (PTCL) is an aggressive hematologic malignancy.
- Accurate prognostic markers are crucial for guiding treatment decisions in PTCL.
- 18F-FDG PET/CT is a key imaging modality for staging and assessing treatment response in lymphoma.
Purpose of the Study:
- To compare the prognostic value of baseline total metabolic tumor volume (TMTV) in PTCL using adaptive thresholding methods versus a fixed 41% SUVmax threshold.
- To evaluate the consistency and reliability of different TMTV measurement techniques in a large PTCL cohort.
Main Methods:
- A retrospective analysis of 106 PTCL patients staged with 18F-FDG PET/CT.
- TMTV was measured using one fixed method (41% SUVmax) and four adaptive thresholding methods (Daisne, Nestle, Fit, Black).
- Prognostic performance was assessed using receiver-operating-characteristic (ROC) curve analysis and Kaplan-Meier survival curves for progression-free and overall survival.
Main Results:
- All TMTV measurement methods showed excellent intraclass correlation coefficients (0.856–0.988), indicating high consistency.
- Adaptive methods (Daisne, Nestle, Fit) showed excellent agreement with the 41% SUVmax method.
- TMTV measurements, regardless of the method used, effectively stratified patients into distinct risk groups with similar prognostic accuracy for progression-free and overall survival.
Conclusions:
- Baseline TMTV is a robust prognosticator in peripheral T cell lymphoma, irrespective of the measurement method (adaptive or fixed threshold).
- The choice of a single, easily applicable, and reproducible TMTV measurement method is essential for multicenter clinical trials.
