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

Abstract

Introduction: In the present study, we aimed to investigate the prognostic value of metabolic parameters, including maximum standardized uptake value (SUV max ), total metabolic tumour volume (tMTV) and total lesion glycolysis (TLG), measured at baseline 18 F-FDG PET/CT in paediatric lymphoma. Methods: From March 2013 to April 2019, 47 patients with paediatric lymphoma, including 38 males and nine females with an average age of 14.87 years, who underwent 18 F-FDG PET/CT scan prior to treatment were retrospectively included in this study. SUV max , MTV and TLG were recorded. Survival curves were established according to the Kaplan-Meier curves and log-rank test. Mann-Whitney U-test was used to assess differences in metabolic parameters between different clinical outcomes. Results: The median follow-up time was 36 months (range of 3-74 months). The 2-year progression-free survival (PFS) of the low TLG and high TLG groups was 95.24% (20/21) and 57.69% (15/26), respectively (P = 0.004). TLG and tMTV were significantly higher in progression-free patients compared with the progression group. Univariate analysis showed that B symptoms (P = 0.014), effusion (P = 0.010), tMTV (P = 0.008) and TLG (P = 0.004) were the predictive factors for PFS. The tMTV (P = 0.005), TLG (P = 0.005) and effusion (P = 0.003) were associated with OS. Multivariate analysis revealed that TLG was the only independent prognostic factor for PFS (HR = 11.133, 95% CI = 1.435-86.405, P = 0.021). Conclusions: Collectively, TLG of baseline 18 F-FDG PET/CT was an independent prognostic factor for PFS in patients with paediatric lymphoma.

Prognostic value of metabolic parameters in baseline 18F-FDG PET/CT for pediatric lymphoblastic lymphoma

“…Conversely, the previous research only contained T-LBL distributed in all stages. In our study, the patients with a low TMTV had good EFS, which is in accordance with the study of Zhou et al 12 . Although not significantly, the patients with a high TMTV had a poor OS.…”

“…They speculated that the correlation between NOTCH mutation status and SUV max may be responsible for this result. In a study involving forty seven children, Zhou et al 12 found that SUV max fails to predict the outcome of pediatric lymphoma. Similar result is shown in our study, in which the SUV max of baseline PET/CT was unrelated to the EFS and OS of children with LBL.…”

“…Images were analyzed by two experienced nuclear medicine physicians to determine lesions by using the Advantage Workstation 4.6 (AW4.6). Focal or diffuse 18 F-FDG uptake above the background excluding normal physiological uptake in PET was considered as a positive lesion as confirmed by the presence of morphologic changes on CT imaging 12 . A focal bone marrow uptake was considered as bone marrow infiltration 13 14 .…”

The Utility of Metabolic Parameters on Baseline F-18 FDG PET/CT in Predicting Treatment Response and Survival in Paediatric and Adolescent Hodgkin Lymphoma

“…Lymphoma is the third most common paediatric malignancy, superseded only by leukemia and central nervous system tumors [1,2]. Collectively, they account for approximately 12% of all childhood cancers, of which about 40% are represented by Hodgkin lymphoma (HL), while the remaining 60% comprise a diverse group of lymphoid malignancies, the non-Hodgkin lymphomas (NHL) [2][3][4]. Unlike lymphoma in adults, indolent lymphomas are rare in children [4].…”

“…Unlike lymphoma in adults, indolent lymphomas are rare in children [4]. Despite the aggressive nature of most paediatric lymphomas, advances in management with a combination of chemotherapy and targeted radiation therapy have resulted in favorable outcomes, with 5-year survival rates reported at 95% and 78% for HL and NHL, respectively [2]. In view of these improvements in survival, current interest has shifted to reducing treatment-related sequelae, which include secondary malignancies and cardiovascular events [1,3,4].…”