Evaluating Novel PET-CT Functional Parameters TLG and TMTV in Differentiating Low-grade Versus Grade 3A Follicular Lymphoma

Major, Ajay; Hammes, Andrew; Schmidt, Matthew Q.; Morgan, Rustain; Abbott, Diana; Kamdar, Manali

doi:10.1016/j.clml.2019.09.609

Cited by 5 publications

(9 citation statements)

References 43 publications

(56 reference statements)

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“…FDG uptake was shown to be higher in aggressive as compared to indolent NHL ( 39 , 40 ). A widely varied SUV max between low-grade and grade 3A FL was observed in many studies ( 31 , 39 ). In a previous study, the cutoff value of SUV max was 10.4, with 64% sensitivity and 74% specificity.…”

Section: Discussionmentioning

confidence: 92%

“…In a previous study, the cutoff value of SUV max was 10.4, with 64% sensitivity and 74% specificity. In addition, TMTV and TLG had a comparable performance to SUV max in making this distinction, with similar sensitivity and specificity values ( 31 ). However, TMTV and TLG could not discriminate low-grade from grade 3A FL in our study.…”

Section: Discussionmentioning

confidence: 99%

“…Given the challenges of histological grading of FL, Major et al ( 31 ) have focused on whether PET/CT can be used as an adjunct to biopsy grading of FL. The results showed that the maximum standardized uptake (SUV max ), TMTV, and TLG were capable of differentiating grade 3A from low-grade (grade 1/2) FL, although this was based on a small number of cases, especially in the grade 3A group (11 patients).…”

Section: Introductionmentioning

confidence: 99%

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Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT

Wang

Fan

et al. 2022

Front. Oncol.

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PurposeWe investigated the utility of a new baseline PET parameter expressing lesion dissemination and metabolic parameters for predicting progression-free survival (PFS) and pathologic grade in follicular lymphoma (FL).MethodsThe baseline 18F-FDG PET/CT images of 126 patients with grade 1–3A FL were retrospectively analyzed. A novel PET/CT parameter characterizing lesion dissemination, the distance between two lesions that were furthest apart (Dmax), was calculated. The total metabolic tumor volume and total lesion glycolysis (TLG) were computed by using 41% of the maximum standardized uptake value (SUVmax) thresholding method.ResultsThe 5-year PFS rate was 51.9% for all patients. In the multivariate analysis, high Dmax [P = 0.046; hazard ratio (HR) = 2.877], high TLG (P = 0.004; HR = 3.612), and elevated serum lactate dehydrogenase (P = 0.041; HR = 2.287) were independent predictors of PFS. A scoring system for prognostic stratification was established based on these three adverse factors, and the patients were classified into three risk categories: low risk (zero to one factor, n = 75), intermediate risk (two adverse factors, n = 29), and high risk (three adverse factors, n = 22). Patients in the high-risk group had a shorter 3-year PFS (21.7%) than those in the low- and intermediate-risk groups (90.6 and 44.6%, respectively) (P < 0.001). The C-index of our scoring system for PFS (0.785) was superior to the predictive capability of the Follicular Lymphoma International Prognostic Index (FLIPI), FLIPI2, and PRIMA-Prognostic Index (C-index: 0.628–0.701). The receiver operating characteristic curves and decision curve analysis demonstrated that the scoring system had better differentiation and clinical utility than these existing indices. In addition, the median SUVmax was significantly higher in grade 3A (36 cases) than in grades 1 and 2 FL (90 cases) (median: 13.63 vs. 11.45, P = 0.013), but a substantial overlap existed (range: 2.25–39.62 vs. 3.17–39.80).ConclusionTLG and Dmax represent two complementary aspects of the disease, capturing the tumor burden and lesion dissemination. TLG and Dmax are promising metrics for identifying patients at a high risk of progression or relapse. Additionally, SUVmax seems to have some value for distinguishing grade 3A from low-grade FL but cannot substitute for biopsy.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT

Wang

Fan

et al. 2022

Front. Oncol.

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“…Recent studies demonstrated a high prognostic value of the end-induction PET scan, a predictor of better survival and superior PFS. [6][7][8][9]11,14 Unfortunately, in this series, only a few patients underwent the metabolic assessment of disease response. The proportion of false-positive PR observed by CT in our series would probably have been reduced.…”

Section: To the Editormentioning

confidence: 99%

Achieving the cure of follicular lymphoma: is it time to finalize treatment strategies to reach this goal in a subset of patients?

Passucci

Assanto

Pulsoni³

2023

Mediterr J Hematol Infect Dis

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“…В недавно опубликованной работе Maior A. et al [35] показано (49 больных ФЛ), что MTV и TLG сопоставимы с SUV max в исходной дифференциальной диагностике различной степени злокачественности ФЛ: низкой -цитологические типы 1 и 2 (low grade) и высокой -цитологический тип 3А (high grade); эти волюметрические показатели значительно выше при типе 3А, чем при типах низкой степени (1 и 2), что может быть учтено при выборе тактики лечения.…”

Section: другие виды неходжкинских лимфом другие виды неходжкинских лимфомunclassified

Metabolic Tumor Volume for Patients with Lymphomas

Vinogradova

Ilyin

Тлостанова

et al. 2021

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Visual analysis of positron emission tomography/computed tomography (PET/CT) scans and semiquantitative parameter of glucose’s standardized uptake value are used in PET/CT with 18F-fluorodeoxyglucose (18F-FDG). Recently some volumetric parameters, which can evaluate metabolic tumor volume for patients with lymphomas and total lesion glycolysis in the tumor sites are established. In our study this problem was analyzed for different types of lymphomas considering clinical importance of these rates and their bond to known factors of international prognostic index.

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Evaluating Novel PET-CT Functional Parameters TLG and TMTV in Differentiating Low-grade Versus Grade 3A Follicular Lymphoma

Cited by 5 publications

References 43 publications

Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT

Prediction of prognosis and pathologic grade in follicular lymphoma using 18F-FDG PET/CT

Achieving the cure of follicular lymphoma: is it time to finalize treatment strategies to reach this goal in a subset of patients?

Metabolic Tumor Volume for Patients with Lymphomas

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