Cancer Res Treat.  2021 Jul;53(3):837-846. 10.4143/crt.2020.123.

Baseline Total Metabolic Tumor Volume and Total Lesion Glycolysis Measured on ¹⁸F-FDG PET-CT Predict Outcomes in T-Cell Lymphoblastic Lymphoma

• Feng X
• Wen X
• Li L
• Sun Z
• Li X
• Zhang L
• Wu J
• Fu X
• Wang X
• Yu H
• Ma X
• Zhang X
• Xie X
• Han X
• Zhang M

• KMID: 2518408
• DOI: http://doi.org/10.4143/crt.2020.123

Abstract

Purpose
There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL.
Materials and Methods
Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test.
Results
The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001).
Conclusion
Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.

Keyword

Total metabolic tumor volume; Total lesion glycolysis; Positron emission tomography-computed tomography; T-cell lymphoblastic lymphoma; Prognosis

Figure

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  Fig. 1 Receiver operator characteristics analysis of maximum standardized uptake value (SUVmax) (A), total metabolic tumor volume (TMTV) (B), and total lesion glycolysis (TLG) (C). AUC, area under curve.

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  Fig. 2 Kaplan-Meier estimates of progression-free survival (A, C, E, G) and overall survival (B, D, F, H) by maximum standardized uptake value (SUVmax) (A, B), total metabolic tumor volume (TMTV) (C, D), total lesion glycolysis (TLG) (E, F), and central nervous system (CNS) (G, H) involvement.

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  Fig. 3 Progression-free survival (A) and overall survival (B) according to risk group stratification combining maximum standardized uptake value, total metabolic tumor volume, total lesion glycolysis, and central nervous system involvement.

Reference

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