End-of-treatment <sup>18</sup>F-FDG PET/CT in diffuse large B cell lymphoma patients: ΔSUV outperforms Deauville score

Allioux, François; Damaj, Gandhi; Vilque, Jean-Pierre; Nganoa, Cathy; Gac, Anne-Claire; Aide, Nicolas; Lasnon, Charline

doi:10.1080/10428194.2021.1948028

Cited by 7 publications

(3 citation statements)

References 31 publications

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“…In the present study, a D-5PS score of 5 showed the highest outcome prediction ability compared to either a score of 3 or 4 on EOT-PET. The reason for this result might be found in the limited number of participants in the study, the heterogeneity of tumors, and changes in the uptake of liver background after treatment ( 9 , 24 ). The use of semiquantitative analysis to assess early response in DLBCL may be preferred over the D-5PS, as the calculation of the RLL appears to be more reproducible than is the D-5PS and possesses higher predictive power.…”

Section: Discussionmentioning

confidence: 97%

Predicting diffuse large B-cell lymphoma outcomes with lesion-to-liver maximum standardized uptake value for interim-treatment and end-of-treatment positron emission tomography-computed tomography

Wang,

Zhang,

Xin

2023

Quant Imaging Med Surg

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Background 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography-computed tomography (PET-CT) has been used in response evaluation systems for malignant lymphomas and is an important tool for determining efficacy and prognosis. The Deauville 5-point scale (D-5PS) is an 18 F-FDG PET-CT image-interpretation protocol for patients with lymphoma. Nevertheless, a number of limitations in visual image interpretation, such as interobserver disagreement and the increase of false-positive results, suggests that new parameters are needed. In this study, we aimed to evaluate the prognostic values of interim-treatment (I-) and end-of-treatment (EOT) PET-CT by comparing D-5PS to the semiquantitative lesion-to-liver maximum standardized uptake value ratio (RLL). Methods A total of 90 patients with diffuse large B-cell lymphoma (DLBCL) (45 I-PET and 45 EOT-PET) were analyzed, and the RLL was calculated. Patients were additionally evaluated using the D-5PS system. We determined the optimal cutoff value of RLL using receiver operating characteristic (ROC) analysis. Kaplan-Meier survival analysis was used to compare the outcome predictions, while multivariate Cox regression analysis was used to identify the predictive factors. Results Among the patients examined, 41 (20 I-PET and 21 EOT-PET) experienced progression, and 49 (25 I-PET, 24 EOT-PET) did not. The optimal cutoff values of the RLL for predicting disease progression were 1.37 for I-PET (sensitivity 75%, specificity 88%) and 2.03 for EOT-PET (sensitivity 45.5%, specificity 100%), while the cutoffs of the D-5PS were scores 4 for I-PET (sensitivity 80%, specificity 72%) and 5 for EOT-PET (sensitivity 40.9%, specificity 100%). The prognostic efficacy was higher for the RLL at interim than for the D-5PS [area under the curve (AUC) =0.848 vs . 0.741]. The EOT prognostic efficacy of both evaluation methods was essentially equivalent (AUC =0.785 vs . 0.725). Univariate and multivariate analyses showed that RLL and D-5PS were independent factors affecting DLBCL outcomes for both interim and EOT assessment. Conclusions RLL and D-5PS have independent predictive values for the interim and EOT evaluation of outcomes in patients with DLBCL. The RLL has better interim predictive ability than does D-5PS and can optimize D-5PS interpretation, thus improving interim outcome prediction.

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Section: Discussionmentioning

confidence: 97%

Predicting diffuse large B-cell lymphoma outcomes with lesion-to-liver maximum standardized uptake value for interim-treatment and end-of-treatment positron emission tomography-computed tomography

Wang,

Zhang,

Xin

2023

Quant Imaging Med Surg

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“…In nuclear medicine, SUV is one of the most important parameters to evaluate the outcome of Positron Emission Tomography (PET) examinations, which are increasingly being used for diagnosis, staging, and therapy response evaluation. Although SUV is characterised by simplicity and ease of use, its measurement is susceptible to many sources of unwanted variability due to physical and biological factors, as well as non-optimised image acquisition, image processing and analysis [ 9 , 10 ]. Changes in SUV between baseline and follow-up studies can help to determine whether tumours are responding to treatment [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Changes in SUV between baseline and follow-up studies can help to determine whether tumours are responding to treatment [ 11 ]. Therefore, it is necessary to minimise the sources of error in SUV estimation to produce a semi-quantitative tool as reliable as possible [ 9 , 10 ]. The SUV accuracy estimation assumes the entire injected dose is administered intravenously, distributing itself completely within the body before the examination is performed; an extravasation event can affect its evaluation.…”

Section: Introductionmentioning

confidence: 99%

Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction

et al. 2023

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Background 18F-FDG PET/CT imaging allows to study oncological patients and their relative diagnosis through the standardised uptake value (SUV) evaluation. During radiopharmaceutical injection, an extravasation event may occur, making the SUV value less accurate and possibly leading to severe tissue damage. The study aimed to propose a new technique to monitor and manage these events, to provide an early evaluation and correction to the estimated SUV value through a SUV correction coefficient. Methods A cohort of 70 patients undergoing 18F- FDG PET/CT examinations was enrolled. Two portable detectors were secured on the patients' arms. The dose-rate (DR) time curves on the injected DRin and contralateral DRcon arm were acquired during the first 10 min of injection. Such data were processed to calculate the parameters ΔpinNOR = (DRinmax- DRinmean)/DRinmax and ΔRt = (DRin(t) − DRcon(t)), where DRinmax is the maximum DR value, DRinmean is the average DR value in the injected arm. OLINDA software allowed dosimetric estimation of the dose in the extravasation region. The estimated residual activity in the extravasation site allowed the evaluation of the SUV's correction value and to define an SUV correction coefficient. Results Four cases of extravasations were identified for which ΔRt [(390 ± 26) µSv/h], while ΔRt [(150 ± 22) µSv/h] for abnormal and ΔRt [(24 ± 11) µSv/h] for normal cases. The ΔpinNOR showed an average value of (0.44 ± 0.05) for extravasation cases and an average value of (0.91 ± 0.06) and (0.77 ± 0.23) in normal and abnormal classes, respectively. The percentage of SUV reduction (SUV%CR) ranges between 0.3% and 6%. The calculated self-tissue dose values range from 0.027 to 0.573 Gy, according to the segmentation modality. A similar correlation between the inverse of ΔpinNOR and the normalised ΔRt with the SUV correction coefficient was found. Conclusions The proposed metrics allowed to characterised the extravasation events in the first few minutes after the injection, providing an early SUV correction when necessary. We also assume that the characterisation of the DR-time curve of the injection arm is sufficient for the detection of extravasation events. Further validation of these hypotheses and key metrics is recommended in larger cohorts.

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2-deoxy-2-[18F]FDG PET Imaging for Therapy Assessment in Hodgkin’s and Non-Hodgkin Lymphomas

Withofs,

Bonnet,

Hustinx

2024

PET Clinics

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End-of-treatment ¹⁸F-FDG PET/CT in diffuse large B cell lymphoma patients: ΔSUV outperforms Deauville score

Cited by 7 publications

References 31 publications

Predicting diffuse large B-cell lymphoma outcomes with lesion-to-liver maximum standardized uptake value for interim-treatment and end-of-treatment positron emission tomography-computed tomography

Predicting diffuse large B-cell lymphoma outcomes with lesion-to-liver maximum standardized uptake value for interim-treatment and end-of-treatment positron emission tomography-computed tomography

Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction

2-deoxy-2-[18F]FDG PET Imaging for Therapy Assessment in Hodgkin’s and Non-Hodgkin Lymphomas

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End-of-treatment 18F-FDG PET/CT in diffuse large B cell lymphoma patients: ΔSUV outperforms Deauville score

Cited by 7 publications

References 31 publications

Predicting diffuse large B-cell lymphoma outcomes with lesion-to-liver maximum standardized uptake value for interim-treatment and end-of-treatment positron emission tomography-computed tomography

Predicting diffuse large B-cell lymphoma outcomes with lesion-to-liver maximum standardized uptake value for interim-treatment and end-of-treatment positron emission tomography-computed tomography

Safety injections of nuclear medicine radiotracers: towards a new modality for a real-time detection of extravasation events and 18F-FDG SUV data correction

2-deoxy-2-[18F]FDG PET Imaging for Therapy Assessment in Hodgkin’s and Non-Hodgkin Lymphomas

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End-of-treatment ¹⁸F-FDG PET/CT in diffuse large B cell lymphoma patients: ΔSUV outperforms Deauville score