Prognosis estimation under the light of metabolic tumor parameters on initial FDG-PET/CT in patients with primary extranodal lymphoma

Abstract

BackgroundNon-Hodgkin’s lymphomas arising from the tissues other than primary lymphatic organs are named primary extranodal lymphoma. Most of the studies evaluated metabolic tumor parameters in different organs and histopathologic variants of this disease generally for treatment response. We aimed to evaluate the prognostic value of metabolic tumor parameters derived from initial FDG-PET/CT in patients with a medley of primary extranodal lymphoma in this study.Patients and methodsThere were 67 patients with primary extranodal lymphoma for whom FDG-PET/CT was requested for primary staging. Quantitative PET/CT parameters: maximum standardized uptake value (SUVmax), average standardized uptake value (SUVmean), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to estimate disease-free survival and overall survival.ResultsSUVmean, MTV and TLG were found statistically significant after multivariate analysis. SUVmean remained significant after ROC curve analysis. Sensitivity and specificity were calculated as 88% and 64%, respectively, when the cut-off value of SUVmean was chosen as 5.15. After the investigation of primary presentation sites and histo-pathological variants according to recurrence, there is no difference amongst the variants. Primary site of extranodal lymphomas however, is statistically important (p = 0.014). Testis and central nervous system lymphomas have higher recurrence rate (62.5%, 73%, respectively).ConclusionsHigh SUVmean, MTV and TLG values obtained from primary staging FDG-PET/CT are potential risk factors for both disease-free survival and overall survival in primary extranodal lymphoma. SUVmean is the most significant one amongst them for estimating recurrence/metastasis.

Prognostic Value of Heterogeneity Index Derived from Baseline 18F-FDG PET/CT in Mantle Cell Lymphoma

“…Okuyucu et al. demonstrated that SUV mean was a potential risk factor for OS in primary extranodal lymphoma ( 36 ). Instead, in our research, SUV max and SUV mean showed no significance with PFS or OS in MCL patients.…”

Prognostic value of baseline 18F‐FDG PET/CT metabolic parameters in paediatric lymphoma

“…According to recently published data, it remains controversial whether MTV and TLG can be used as prognosticators . Sharma et al .…”

“…have found that a high level of TLG is the only significant predictive factor for relapse‐free survival. Okuyucu et al . have found that SUV mean , MTV and TLG are potential risk factors for outcomes in patients with primary extranodal lymphoma (DLBCL, MALT, Burkitt and mantle cell lymphoma).…”

“…This discrepancy might be attributed to the marginal thresholds measured by different ways. In some studies, tMTV is measured by using a threshold method based on 25–50% of the SUV max . This potentially underestimates the volume of lesions with a high SUV max .…”

Metabolic Tumor Volume for Patients with Lymphomas

“…Оказалось, что высокий уровень TLG связан с беспрогрессивной выживаемостью (р = 0,02); уровень MTV имеет выраженную тенденцию к этому (р = 0,06). Okuyucu K. et al [37] у 67 больных экстранодальными неходжкинскими лимфомами показали, что высокие базовые показатели MTV и TLG являются потенциальными факторами риска ухудшения как общей, так и безрецидивной выживаемости. Кроме того, имела значение и локализация опухоли: при поражении яичек и ЦНС риск рецидива был выше.…”