Baseline total metabolic tumor volume combined with international peripheral T-cell lymphoma project may improve prognostic stratification for patients with peripheral T-cell lymphoma (PTCL)

Abstract

Purpose The aim of this study was to explore the prognostic value of total metabolic tumor volume (TMTV) at baseline 18F-FDG PET/CT in patients diagnosed with peripheral T-cell lymphoma (PTCL). Materials and methods Eighty-four newly diagnosed PTCL patients who underwent baseline 18F-FDG PET/CT prior to treatment between March 2009 and January 2019 were enrolled in this retrospective study. The FDG-avid lesions in each patient were segmented using semiautomated software to calculate the maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG) values using the boundaries of voxels presenting with the 41% SUVmax threshold method. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate patient prognosis. The log-rank test and Cox regression analyses were used to evaluate PFS and OS. Results ROC curve analysis indicated an ideal TMTV cut-off value of 228.8 cm3. During the 4–131 months (29.2 ± 28.5 months) follow-up period, high TMTV was significantly associated with worse PFS and OS. TMTV and the international peripheral T-cell lymphoma project score (IPTCLP) were independent predictors of PFS and OS with multivariate analysis. The combination of TMTV and the IPTCLP may provide significantly better risk substratification in PFS and OS of PTCL patients. Conclusions Both TMTV and IPTCLP are independent predictors of PTCL patient survival outcomes. Moreover, the combination of TMTV and IPTCLP improved patient risk stratification and may contribute to personalized therapeutic regimens.

Prognostic value of baseline total metabolic tumour volume of 18F-FDG PET/CT imaging in patients with angioimmunoblastic T-cell lymphoma

“…Kaplan–Meier survival analysis showed that patients in the intermediate/high-risk group had significantly lower rates of PFS and OS than those in the low-risk group. This indicated that the combination of TMTV and PIT also had satisfactory performance and added value to prognostic stratification in AITL, which was partly confirmed by the studies of Cottereau et al and Jiang et al [ 24 , 25 ].…”

“…Therefore, as volume metrics, both of them can represent the total tumour burden to a certain extent, reflect the severity of the disease, and have important potential in the prognostic stratification of AITL. A number of studies have shown that baseline TMTV and TLG have ideal prognostic value in lymphoma [ 18 , 22 – 24 ]. Cottereau et al and Zhou et al used 41% SUVmax as the threshold to study the prognostic value of baseline TMTV and TLG in PTCL [ 18 , 25 ].…”

Full automation of total metabolic tumor volume from FDG-PET/CT in DLBCL for baseline risk assessments

“…The observation of a significant role of aTMTV in predicting survival outcomes in such a setting emphasizes the strength of aTMTV as a prognostic biomarker for identification of patients with DLBCL at high risk at the time of diagnosis, regardless of response to therapy [32]. Furthermore, the combination of TMTV with clinical variables has been shown to improve patient-risk stratification in a previous study of patients with peripheral T-cell lymphoma [37], which also supports the integration of automated imaging metrics into models comprised of clinical variables alone.…”

The added prognostic values of baseline PET dissemination parameter in patients with angioimmunoblastic T‐cell lymphoma

“…This requires a reliable risk stratification model. Parameters extracted from baseline PET can play an important role for FDG-avid AITL patients[8,19]. Due toTA B L E 4Abbreviations: AITL, Angioimmunoblastic T-cell lymphoma; BMI, bone marrow involvement; CI, confidence interval; CRP, C-reactive protein; Dmax, the distance between the two lesions that are the furthest apart; EBV-DNA, Epstein-Barr virus DNA; ECOG-PS, Eastern Cooperative Oncology Group performance status; ENIs, extranodal involvement sites; HR, hazard ratio; IPI, International Prognostic Index; PIAI, Prognostic Index for AITL; PIT, Prognostic Index for T-cell lymphoma; PLT, platelet; ref, reference.…”