Interim FDG PET/CT as a prognostic factor in diffuse large B-cell lymphoma

Abstract

Our results support the use of liver uptake as an indicator in the qualitative evaluation of interim PET, or a ΔSUVmax greater than 75 % in semiquantitative analysis. Interim PET may predict PFS and OS and could be considered in the prognostic evaluation of DLBCL.

Interim fluorine-18 fluorodeoxyglucose PET-computed tomography and cell of origin by immunohistochemistry predicts progression-free and overall survival in diffuse large B-cell lymphoma patients in the rituximab era

“…Some studies have reported that a negative iPET-CT is associated with better OS and event-free survival 23. Yet, other studies have not confirmed these outcomes, in part because they have used different analysis methods for 18 F-FDG-PET imaging and determining response 15,24,25. Lanic et al 19, using GEPs in 57 cases of DLBCL, applied a semiquantitative method to interpret the iPET-CT using SUV max reduction with a value less than 70% for slow metabolic responders and higher than 70% for fast responders 19,26,27.…”

Early treatment intensification with R-ICE and 90Y-ibritumomab tiuxetan (Zevalin)-BEAM stem cell transplantation in patients with high-risk diffuse large B-cell lymphoma patients and positive interim PET after 4 cycles of R-CHOP-14

“…36 In the present study, some iPET scans potentially considered Deauville score 3 may have been interpreted as score 2 for the purposes of IHP criteria; however, the 29% rate of iPET-positivity is highly consistent with that reported among high-risk patients in other studies using the 5-PS. 16,29,30 Some investigators have evaluated a quantitative PET approach, with reports suggesting that iPET analysis using ΔSUV max provides a higher PPV than qualitative analysis and therefore lower rates of PET-positivity. 21,[37][38][39][40] However, these studies have predominantly assessed the ΔSUV max at iPET-2, as well as using somewhat variable cut-off values, with a lack of congruence between PET centers and limited validation in multi-center trials.…”

“…In a post-hoc exploratory analysis iPET-positive scans were scored by 2 blinded readers with a visual interpretation using the Deauville 5-PS, 15,[29][30][31][32] and survival outcomes were evaluated accordingly. Of the entire 42 iPET-positive patients, 27 were Deauville score 4 and 15 were score 5.…”

Retrospective Analysis of a New Prognostic Score for Diffuse Large B-Cell Lymphoma Based on Interim Positron Emission Tomography-Computed Tomography

“…The Deauville standard in interpretation of interim PET-CT has been recommended by 2013 NCCN guidelines [6]. Because studies have shown that there was a high NPV but the PPV was not ideal [7], additional studies have employed quantitative methods to further improve the Deauville standard [19, 34]. The present study used the standards recommended by the international lymphoma imaging diagnostic panel [10] because the Deavuille standard is not used at our center, and it is possible that patients did not undergo PET-CT examination before treatment or the examination was performed at another research center.…”