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. 2018 Nov;91(1091):20180240.
doi: 10.1259/bjr.20180240. Epub 2018 Jul 25.

Prognostic value of interim fluorodeoxyglucose and fluorothymidine PET/CT in diffuse large B-cell lymphoma

Ruimin Wang  1 , Baixuan Xu  1 , Changbin Liu  1 , Zhiwei Guan  1 , Jinming Zhang  1 , Fei Li  2 , Lu Sun  3 , Haiyan Zhu  2
Affiliations

Prognostic value of interim fluorodeoxyglucose and fluorothymidine PET/CT in diffuse large B-cell lymphoma

Ruimin Wang et al. Br J Radiol. 2018 Nov.

Abstract

Objective:: To examine the prognostic value of fluorodeoxyglucose (FDG) and fluorothymidine (FLT) interim positron emission tomography/CT (PET/CT) for diffuse large B-cell lymphoma (DLBCL).

Methods:: 44 patients with newly diagnosed DLBCL underwent both fluorine 18 FDG (18F-FDG) and 18F-FLT PET/CT scans at baseline and after two cycles of a rituximab-containing chemotherapy regimen. Maximum standard uptake values (SUVmax) and changes in SUV (ΔSUV) were calculated for both tracers for the predominant lesion of each patient, for prediction of progression-free survival (PFS) and overall survival (OS).

Results:: The median follow-up period was 71 months. Receiver operating characteristic (ROC) analysis indicated that the best ΔSUV cut-off values for FDG (ΔSUVFDG) and FLT (ΔSUVFLT) were 79 and 76%, respectively. A ΔSUVFLT cut-off of 76% had the highest significance for prediction of PFS (p = 0.003) and OS (p = 0009), with sensitivity, specificity, and accuracy of 80.0, 85.7, and 81.8% respectively in response assessment.

Conclusion:: Interim FLT PET/CT had higher specificity and accuracy than standard FDG PET/CT-based interpretation.

Advances in knowledge:: This study demonstrated that interim FLT PET/CT had higher accuracy than standardized FDG-based interpretation for therapeutic response assessment in DLBCL. FLT had the advantage of potentially reducing false positive of interim FDG PET/CT.

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Conflict of interest statement

Acknowledgements: We thank Karl Embleton, PhD, for editing the English text of a draft of this manuscript.

Figures

Figure 1.
Figure 1.
ROC analysis of ΔSUVFDG and ΔSUVFLT in the prediction of complete remission in diffuse large B-cell lymphoma patients. The areas under the curves of ΔSUVFDG and ΔSUVFLT were 0.769 and 0.762 respectively. ROC, receiver operating characteristic; SUV, standard uptake value; ΔSUVFDG, ΔSUV cut-off values for FDG (fluorodeoxyglucose); ΔSUVFLT, ΔSUV cut-off values for FLT (fluorothymidine).
Figure 2.
Figure 2.
Kaplan-Meier estimates of progression free survival stratified by different cut-off values for ΔSUVFDG, ΔSUVFLT, and the Deauville scale. SUV, standard uptake value; ΔSUVFDG, ΔSUV cut-off values for FDG (fluorodeoxyglucose); ΔSUVFLT, ΔSUV cut-off values for FLT (fluorothymidine).
Figure 3.
Figure 3.
Kaplan–Meier estimates of overall survival stratified by different cut-off values for ΔSUVFDG, ΔSUVFLT, and the Deauville scale. SUV, standard uptake value; ΔSUVFDG, ΔSUV cut-off values for FDG (fluorodeoxyglucose); ΔSUVFLT, ΔSUV cut-off values for FLT (fluorothymidine).
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