Predictive value of F-18 FDG PET/CT quantization parameters in diffuse large B cell lymphoma: a meta-analysis with 702 participants

Abstract

F-18 fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) is considered to be the most beneficial imaging method for staging patients with lymphoma. Whether maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) acquired from F-18 FDG PET/CT are predictors of prognosis of diffuse large B cell lymphoma (DLBCL) is controversial, with some studies concluding that it is and others concluding the opposite. Therefore, a systematic review was performed to explore the relationship of F-18 FDG PET/CT quantization parameters with the prognosis of DLBCL. Seven trials with a total of 703 DLBCL patients were included for analysis. Hazard ratios (HRs) for progression-free survival (PFS) and overall survival (OS), and odds ratios (ORs) for 3-year PFS and OS were pooled using the STATA package. Combined results suggested a strong link between the high SUVmax, MTV and TLG values and the poor 3-year PFS with ORs of 2.59, 3.69 and 2.29, respectively. Similarly, high MTV and TLG values unfavorably influenced the 3-year OS with ORs of 5.40 and 2.19, respectively. The pooled results also showed that high SUVmax and MTV were negative predictors of PFS with HRs of 1.61 (p = 0.038) and 2.18 (p = 0.000), respectively. The TLG value was not predictive of PFS. And for OS, only high MTV was a strong predictor of poor prognosis in DLBCL with HR 2.99 (p = 0.000). Our results suggested that SUVmax and MTV may be significant prognostic markers for PFS and MTV may be the only predictor for OS in DLBCL.

18F-FDG PET for Measurement of Response and Prediction of Outcome to Relapsed or Refractory Mantle Cell Lymphoma Therapy with Bendamustine–Rituximab

“…Reports assessing the predictive value of 18 F-FDG PET after chemotherapy (most retrospective, with some prospective analyses in time-to-event studies) include the following hematologic malignancies: MCL (11,17,18), follicular lymphoma (19,20), chronic lymphoid leukemia/DLBCL (12,(21)(22)(23), and peripheral T-cell lymphomas (24).…”

Large-scale microarray profiling reveals four stages of immune escape in non-Hodgkin lymphomas

“…The SES for "glycolysis and gluconeogenesis" were low in CLL, HCL, MCL, and resting normal Bcells, whereas such scores were significantly higher in normal proliferating B-cells, BL, DLBCL, FL, and MZL, in line with results from 16 FDG-PET imaging of these tumors. [34][35][36] Combining the SES for "Glycolysis" and "OxPhos" illustrated the distinct metabolic profiles of the different neoplasms ( Fig. 2C and Fig.…”

Metabolic Tumor Volume: We Still Need a Platinum-Standard Metric

“…For OS, only high MTV was a strong predictor of poor prognosis (P 5 0.000). When Ann Arbor staging did not predict survival, higher MTV was associated with a significantly inferior event-free survival or PFS compared with the lower-MTV group, independent of the IPI (4,5). Similar to HL data, the combination of baseline MTV and interim PET performed after 2 cycles of chemotherapy findings improved the predictive value (8).…”

“…Essentially, a shared unit of optimal measure, a platinum-standard metric, proving accurate and comparable results quantitatively still remains to be developed (5). The reported results for TMTV computing and the variability of MTV cutoff values to predict treatment outcome point toward a prognostic role of MTV as a continuous instead of a dichotomous variable to identify patient outcome.…”

“…In aggressive B-cell lymphoma (DLBCL), multiple retrospective studies investigated pretreatment PET-derived volumetrics as a potential predictor of survival in patients undergoing R-CHOP therapy (5)(6)(7)(8)(9). A systematic review of 7 retrospective DLBCL studies (n 5 703) suggested that both SUV max and MTV were significant prognostic factors for PFS (P 5 0.038 and 0.000, respectively) (5).…”