Nucl Med Mol Imaging.  2010 Apr;44(1):39-44.

Tumor Burden Assessed by the Maximum Standardized Uptake Value and Greatest Diameter on FDG-PET Predicts Prognosis in Untreated Diffuse Large B-cell Lymphoma

Affiliations
  • 1Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea. wwlee@snu.ac.kr
  • 2Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 3Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
  • 4Department of Nuclear Medicine, Cho Ray Hospital, Ho Chi Minh City, Viet Nam.
  • 5Department of Nuclear Medicine Diagnosis and Therapy, Cairo University, Cairo, Egypt.

Abstract

PURPOSE
It is uncertain whether the tumor burden as assessed using FDG-PET has prognostic significance in newly diagnosed diffuse large B-cell lymphoma (DLBCL). The authors undertook this study to determine whether a parameter that reflects both FDG uptake magnitude and the greatest tumor diameter is a prognostic indicator in DLBCL.
MATERIALS AND METHODS
Forty-two DLBCL patients (age, 57.4+/-15.5 years; male/female=25/17; stage I/II/III/IV=5/17/10/10) who underwent FDG-PET before chemotherapy were enrolled. A lesion with the highest maximum standardized uptake value (MaxSUV) on the PET image was selected, and size-incorporated MaxSUV (SIMaxSUV) of mass was calculated as MaxSUV x greatest diameter (mm) on the transaxial PET image. Median follow-up duration was 20.0 months.
RESULTS
Twelve (28.6%=12/42) patients experienced disease progression, and 10 (23.8%=10/42) died during follow-up. Among six variables [Ann Arbor stage, %Ki-67 expression, International Prognostic Index (IPI), MaxSUV, greatest diameter, and SIMaxSUV] investigated, only SIMaxSUV was found to be a single determinant of progression-free and overall survivals by multivariate analyses (p<0.05).
CONCLUSION
These results suggest that SIMaxSUV, a new FDG-PET parameter that incorporates FDG uptake magnitude and the greatest tumor diameter, may be a useful indicator of prognosis in untreated DLBCL.

Keyword

FDG-PET; Lymphoma; Prognosis; SUV; Size-incorporated maxSUV; Greatest diameter

MeSH Terms

B-Lymphocytes
Disease Progression
Follow-Up Studies
Humans
Lymphoma
Lymphoma, B-Cell
Multivariate Analysis
Prognosis
Tumor Burden
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