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

Area of Science:

• Nuclear Medicine
• Oncology
• Radiology

Background:

• Elderly Hodgkin lymphoma (HL) is an aggressive subgroup with high 18F-FDG avidity.
• Lack of standardized PET/CT criteria for treatment evaluation and outcome prediction in elderly HL.

Purpose of the Study:

• To investigate if baseline 18F-FDG-PET/CT metabolic parameters can predict treatment response and prognosis in elderly HL patients.
• To establish predictive criteria for treatment response and long-term outcomes in this specific patient population.

Main Methods:

• Retrospective analysis of 123 elderly HL patients with baseline and end-of-treatment 18F-FDG-PET/CT scans.
• Semi-quantitative PET/CT analysis including lesion to liver SUVmax ratio (L-L SUV R), lesion to blood-pool SUVmax ratio (L-BP SUV R), metabolic tumor volume (MTV), and total lesion glycolysis (TLG).
• Kaplan-Meier survival analysis and correlation with end-of-treatment Deauville criteria.

Main Results:

• Higher baseline L-BP SUV R, L-L SUV R, MTV, and TLG were associated with no complete response at end of treatment.
• L-L SUV R and L-BP SUV R were independent prognostic factors for progression-free survival (PFS) and overall survival (OS).
• End-of-treatment PET/CT results using Deauville criteria strongly correlated with treatment response and survival outcomes.

Conclusions:

• Baseline semi-quantitative PET/CT parameters are valuable predictors of treatment response and prognosis in elderly HL.
• Integrating baseline metabolic parameters with end-of-treatment Deauville criteria can improve outcome prediction and treatment evaluation in elderly HL.