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  11. Evaluation Of Therapeutic Effect And Prognostic Value Of 18f-fdg Pet/ct In Different Treatment Nodes Of Dlbcl Patients.

Evaluation of therapeutic effect and prognostic value of 18F-FDG PET/CT in different treatment nodes of DLBCL patients.

Wenyu Zhao1, Xiaodong Wu1,2, Shuo Huang1

  • 1Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.

EJNMMI Research
|February 19, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Interim 18F-FDG PET/CT scans in diffuse large B cell lymphoma (DLBCL) can predict treatment outcomes. Combining visual and semi-quantitative analysis improves the accuracy of identifying patients who may need more intensive therapy early on.

Area of Science:

  • Nuclear Medicine
  • Oncology
  • Radiomics

Background:

  • Diffuse large B cell lymphoma (DLBCL) prognosis assessment is crucial for treatment stratification.
  • 18F-FDG PET/CT is a key imaging modality in DLBCL management.
  • Early identification of patients with poor prognosis can guide treatment intensification.

Purpose of the Study:

  • To evaluate the prognostic role of baseline, interim, and end-of-treatment 18F-FDG PET/CT in DLBCL.
  • To identify patients requiring early intensive treatment based on imaging parameters.
  • To compare the predictive accuracy of visual analysis versus semi-quantitative parameters.

Main Methods:

  • Retrospective analysis of 127 DLBCL patients undergoing 18F-FDG PET/CT at baseline, interim, and end-of-treatment.
Keywords:
DLBCLPET/CTR/RSemi-quantitative parameters

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  • Semi-quantitative analysis included SUVmax(LLR), SUVmax(LMR), TMTV, and TLG, along with their changes (ΔSUVmax, ΔTMTV, ΔTLG).
  • Visual analysis using the Deauville 5-point scale (D-5PS) and statistical methods (Kaplan-Meier, Cox regression) were employed.

    • Main Results:

    • Interim PET/CT parameters, including ΔSUVmax(LLR), ΔTMTV, and ΔTLG, significantly predicted progression-free survival (PFS) and overall survival (OS).
    • Incomplete metabolic remission on interim and end-of-treatment PET/CT correlated with increased risk of progression and death.
    • Combined visual and semi-quantitative analysis of interim PET/CT demonstrated higher positive predictive value and specificity for predicting recurrence.

    Conclusions:

    • Interim 18F-FDG PET/CT after 3-4 cycles of R-CHOP can predict early recurrence or refractory disease in DLBCL.
    • Combining visual and semi-quantitative analysis of interim 18F-FDG PET/CT enhances prognostic accuracy.
    • This combined approach facilitates precise screening for patients who may benefit from early intensive therapy.
    Survival
    Visual analysis