Prognostic significance of retention index of bone marrow on dual-phase 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with diffuse large B-cell lymphoma

Chang, Chia‐Ming; Cho, Shih‐Feng; Chuang, Ya‐Wen; Lin, Chia-Yang; Huang, Ying‐Fong; Tyan, Yu‐Chang

doi:10.1097/md.0000000000009513

Cited by 7 publications

(3 citation statements)

References 39 publications

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“…In several types of cancer, increased FDG avidity of the bone marrow seemed to be associated with prognostic factors such as lower overall survival rate and higher cancer recurrence rate [9][10][11][12][13][14]. In our cohort of patients with bacteremia, BLR or SLR was not associated with a total duration of hospital stay, ICU admission, or mortality.…”

Section: Discussionmentioning

confidence: 52%

“…The bone marrow and spleen are generally regarded as "hypermetabolic" when their FDG avidity exceeds that of the liver (bone marrow/liver ratio or spleen/liver ratio > 1.0) [8]. Hypermetabolism of the bone marrow or spleen has been associated with laboratory values such as C-reactive protein or hemoglobin and even prognosis in patients with several types of cancer [9][10][11][12][13][14] and autoimmune disease [15,16]. However, the clinical and pathophysiological meaning of hypermetabolism of the bone marrow and spleen in patients with bacteremia is limited.…”

Section: Introductionmentioning

confidence: 99%

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Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia

Pijl

Kwee

Slart

et al. 2020

Eur J Nucl Med Mol Imaging

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Purpose To investigate which clinical factors and laboratory values are associated with high FDG uptake in the bone marrow and spleen on 2-deoxy-2-[18F]fluoro-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with bacteremia. Methods One hundred forty-five consecutive retrospective patients with bacteremia who underwent FDG-PET/CT between 2010 and 2017 were included. Mean standard uptake values (SUVmean) of FDG in bone marrow, liver, and spleen were measured. Bone marrow-to-liver SUV ratios (BLR) and spleen-to-liver SUV ratios (SLR) were calculated. Linear regression analyses were performed to examine the association of BLR and SLR with age, gender, hemoglobin, leukocyte count, platelets, glucose level, C-reactive protein (CRP), microorganism, days of antibiotic treatment before FDG-PET/CT, infection focus, use of immunosuppressive drugs, duration of hospital stay (after FDG-PET/CT), ICU admission, and mortality. Results C-reactive protein (p = 0.006), a cardiovascular or musculoskeletal focus of infection (p = 0.000 for both), and bacteremia caused by Gram-negative bacteria (p = 0.002) were independently and positively associated with BLR, while age (p = 0.000) and glucose level before FDG-PET/CT (p = 0.004) were independently and negatively associated with BLR. For SLR, CRP (p = 0.001) and a cardiovascular focus of infection (p = 0.020) were independently and positively associated with SLR, while age (p = 0.002) and glucose level before FDG-PET/CT (p = 0.016) were independently and negatively associated with SLR. Conclusion High FDG uptake in the bone marrow is associated with a higher inflammatory response and younger age in patients with bacteremia. In patients with high FDG uptake in the bone marrow, a cardiovascular or musculoskeletal focus of infection is more likely than other foci, and the infection is more often caused by Gram-negative species. High splenic FDG uptake is associated with a higher inflammatory response as well, and a cardiovascular focus of infection is also more likely in case of high splenic FDG uptake.

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Section: Discussionmentioning

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia

Pijl

Kwee

Slart

et al. 2020

Eur J Nucl Med Mol Imaging

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“…The standardized uptake value (SUV) is the most commonly used parameter in FDG PET/CT and has been proved to be a significant prognostic predictor in DLBCL 13 , 14 . The percentage change in maximal SUV (SUVmax) between initial and delayed phase images is defined as the retention index (RI) which is found to have significant prognostic potential to predict overall survival (OS) in patient with DLBCL 15 . Beyond SUV and RI, the total metabolic tumor volume (MTVsum) has also been shown to be a predictor for survival outcome in many previous studies 16 – 19 .…”

Section: Introductionmentioning

confidence: 99%

Iterated cross validation method for prediction of survival in diffuse large B-cell lymphoma for small size dataset

Chang

Chen

Hsieh

et al. 2023

Sci Rep

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Efforts have been made to improve the risk stratification model for patients with diffuse large B-cell lymphoma (DLBCL). This study aimed to evaluate the disease prognosis using machine learning models with iterated cross validation (CV) method. A total of 122 patients with pathologically confirmed DLBCL and receiving rituximab-containing chemotherapy were enrolled. Contributions of clinical, laboratory, and metabolic imaging parameters from fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) scans to the prognosis were evaluated using five regression models, namely logistic regression, random forest, support vector classifier (SVC), deep neural network (DNN), and fuzzy neural network models. Binary classification predictions for 3-year progression free survival (PFS) and 3-year overall survival (OS) were conducted. The 10-iterated fivefold CV with shuffling process was conducted to predict the capability of learning machines. The median PFS and OS were 41.0 and 43.6 months, respectively. Two indicators were found to be independent predictors for prognosis: international prognostic index and total metabolic tumor volume (MTVsum) from FDG PET/CT. For PFS, SVC and DNN (both with accuracy 71%) have the best predictive results, of which outperformed other algorithms. For OS, the DNN has the best predictive result (accuracy 76%). Using clinical and metabolic parameters as input variables, the machine learning methods with iterated CV method add the predictive values for PFS and OS evaluation in DLBCL patients.

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The prognostic value of bone marrow retention index and bone marrow-to-liver ratio of baseline 18F-FDG PET/CT in diffuse large B-cell lymphoma

El-Azony,

Basha,

Almalki

et al. 2023

Eur Radiol

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Prognostic significance of retention index of bone marrow on dual-phase 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with diffuse large B-cell lymphoma

Abstract: Supplemental Digital Content is available in the text

Cited by 7 publications

References 39 publications

Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia

Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia

Iterated cross validation method for prediction of survival in diffuse large B-cell lymphoma for small size dataset

The prognostic value of bone marrow retention index and bone marrow-to-liver ratio of baseline 18F-FDG PET/CT in diffuse large B-cell lymphoma

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