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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).
See this image and copyright information in PMC

References

    1. Cultrera JL, Dalia SM. Diffuse large B-cell lymphoma: current strategies and future directions. Cancer Control 2012; 19: 204–13. doi: 10.1177/107327481201900305 - DOI - PubMed
    1. Gisselbrecht C, Glass B, Mounier N, Singh Gill D, Linch DC, Trneny M, et al. Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era. J Clin Oncol 2010; 28: 4184–90. doi: 10.1200/JCO.2010.28.1618 - DOI - PMC - PubMed
    1. Miyazaki Y, Nawa Y, Miyagawa M, Kohashi S, Nakase K, Yasukawa M, et al. Maximum standard uptake value of 18F-fluorodeoxyglucose positron emission tomography is a prognostic factor for progression-free survival of newly diagnosed patients with diffuse large B cell lymphoma. Ann Hematol 2013; 92: 239–44. doi: 10.1007/s00277-012-1602-3 - DOI - PMC - PubMed
    1. Akkas BE, Vural GU. Standardized uptake value for (18)F-fluorodeoxyglucose is correlated with a high International Prognostic Index and the presence of extranodal involvement in patients with diffuse large B-cell lymphoma. Rev Esp Med Nucl Imagen Mol 2014; 33: 148–52. doi: 10.1016/j.remn.2013.07.008 - DOI - PubMed
    1. Itti E, Meignan M, Berriolo-Riedinger A, Biggi A, Cashen AF, Véra P, et al. An international confirmatory study of the prognostic value of early PET/CT in diffuse large B-cell lymphoma: comparison between Deauville criteria and ΔSUVmax. Eur J Nucl Med Mol Imaging 2013; 40: 1312–20. doi: 10.1007/s00259-013-2435-6 - DOI - PubMed

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