Korean J Intern Med.  2024 Mar;39(2):327-337. 10.3904/kjim.2023.323.

Prognostic Significance Of Sequential ¹⁸f-fdg Pet/Ct During Frontline Treatment Of Peripheral T Cell Lymphomas

• Song GY
• Jung SH
• Ahn SY
• Kim M
• Ahn JS
• Lee JJ
• Kim HJ
• Moon JB
• Yoo SW
• Kwon SY
• Min JJ
• Bom HS
• Kang SR
• Yang DH

• KMID: 2552951
• DOI: http://doi.org/10.3904/kjim.2023.323

Abstract

Background/Aims
The prognostic significance of 18^F-fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET/CT) in peripheral T-cell lymphomas (PTCLs) are controversial. We explored the prognostic impact of sequential 18^F-FDG PET/CT during frontline chemotherapy of patients with PTCLs.
Methods
In total, 143 patients with newly diagnosed PTCLs were included. Sequential 18^F-FDG PET/CTs were performed at the time of diagnosis, during chemotherapy, and at the end of chemotherapy. The baseline total metabolic tumor volume (TMTV) was calculated using the the standard uptake value with a threshold method of 2.5.
Results
A baseline TMTV of 457.0 cm3 was used to categorize patients into high and low TMTV groups. Patients with a requirehigh TMTV had shorter progression-free survival (PFS) and overall survival (OS) than those with a low TMTV (PFS, 9.8 vs. 26.5 mo, p = 0.043; OS, 18.9 vs. 71.2 mo, p = 0.004). The interim 18^F-FDG PET/CT response score was recorded as 1, 2–3, and 4–5 according to the Deauville criteria. The PFS and OS showed significant differences according to the interim 18^F-FDG PET/CT response score (PFS, 120.7 vs. 34.1 vs. 5.1 mo, p < 0.001; OS, not reached vs. 61.1 mo vs. 12.1 mo, p < 0.001).
Conclusions
The interim PET/CT response based on visual assessment predicts disease progression and survival outcome in PTCLs. A high baseline TMTV is associated with a poor response to anthracycline-based chemotherapy in PTCLs. However, TMTV was not an independent predictor for PFS in the multivariate analysis.

Keyword

Peripheral T-cell lymphoma; PET-CT scan; Prognosis; Progression-free survival