Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 5:14:100663.
doi: 10.1016/j.ejro.2025.100663. eCollection 2025 Jun.

[18F]FDG-PET/CT in DLBCL-patients treated with CAR-T cell therapy: potential for defining patient prognosis

Helena A Peters  1   2 , Ben-Niklas Bärmann  3 , Emil Novruzov  1   2 , Daniel Weiss  1   2 , Matthias Boschheidgen  1   2 , Vivien Lorena Ivan  1   2 , Nora Liebers  3 , Johannes Fischer  3 , Eduards Mamlins  1   2 , Aleksandar Radujkovic  3 , Guido Kobbe  3 , Julian Kirchner  1   2 , Peter Minko  1   2 , Kathrin Nachtkamp  3 , Paul Jäger  3 , Christina Antke  1   2 , Frederik L Giesel  1   2 , Sascha Dietrich  3 , Gerald Antoch  1   2   4 , Kai Jannusch  1   2
Affiliations

[18F]FDG-PET/CT in DLBCL-patients treated with CAR-T cell therapy: potential for defining patient prognosis

Helena A Peters et al. Eur J Radiol Open. .

Abstract

Objectives: The aim of this study is to evaluate the potential of [18F]FDG-PET/CT in terms of prognostic value and treatment monitoring in relapsed / refractory diffuse large B-cell lymphoma (DLBCL)-patients treated with chimeric antigen receptor T-cell (CAR-T) therapy.

Material & methods: Forty-eight [18F]FDG-PET/CT scans, acquired at pre-defined time points (t0 - t2) of 18 DLBCL-patients (mean age: 60 ± 12 years) treated with CAR-T cell therapy were retrospectively enrolled. Median time of follow-up was ten months (IQR 6-16) following CAR-T cell infusion. SUVmax, sum of the product of diameters (SPD), Deauville score (DS) and Lugano classification (LC) were evaluated. Clinical parameters (age, sex) were obtained. Survival time analyses for progression-free survival (PFS) and overall survival (OS) were calculated, the latter by using the Kaplan-Meier method and Cox regression including a hazard ratio (HR). P values below 0.05 were defined as statistically significant. 95 %-confidence intervals (CI) were calculated.

Results: Patients with a SUVmax> 9.0 at t0 (median as threshold value) had a significantly shorter PFS (p = 0.04) and OS (p < 0.01). According to LC, a progressive disease (PD) at t1 (p = 0.02) and t2 (p < 0.01) was correlated with a reduced OS. SUVmax > 9.0 at t0 (p = 0.03, HR = 7.0, CI: 1.3-40.5) and DS > 3 at t1 (p = 0.04, HR = 8.2, CI: 1.1-61.3) were associated with an increased risk of a PD.

Conclusion: SUVmax of [18F]FDG-PET/CT seems to be useful as a prognostic marker in DLBCL-patients undergoing CAR-T cell therapy. Furthermore, scores of clinical established Deauville classification and Lugano response criteria acquired at post-CAR-T [18F]FDG-PET/CT might be an indicator for early therapy failure.

Keywords: CAR-T; Diffuse large B cell lymphoma; FDG-PET/CT; Overall survival; Progression-free survival.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
[18F]FDG-PET/CT examination of a fifty-one-year-old patient with DLBCL and pleural lymphoma manifestation and infiltration of adjacent rib. Example of image analysis with (A) measurement the SUVmax in the tumor area with the highest metabolic activity using a volume of interest (VOI), and (B) measurement of maximal (y) and minimal (x) diameters in mm.
Fig. 2
Fig. 2
Kaplan-Meier curves of SUVmax at t0. Progression-free survival (left) and overall survival (right) proportion against time in days are plotted in each diagram.
Fig. 3
Fig. 3
Kaplan-Meier curves of Lugano classification at t1 (left) und t2 (right): Complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Overall survival proportion against time in days are plotted in each diagram.
See this image and copyright information in PMC

References

    1. Locke F.L., et al. Long-term safety and activity of axicabtagene ciloleucel in refractory large B-cell lymphoma (ZUMA-1): a single-arm, multicentre, phase 1–2 trial. Lancet Oncol. 2019;20(1):31–42. - PMC - PubMed
    1. Schuster S.J., et al. Tisagenlecleucel in adult relapsed or refractory diffuse large B-cell lymphoma. N. Engl. J. Med. 2019;380(1):45–56. - PubMed
    1. Schuster S.J., Investigators J. Tisagenlecleucel in diffuse large B-cell lymphoma. Reply. N. Engl. J. Med. 2019;380(16):1586. - PubMed
    1. Abramson J.S., et al. Lisocabtagene maraleucel for patients with relapsed or refractory large B-cell lymphomas (TRANSCEND NHL 001): a multicentre seamless design study. Lancet. 2020;396(10254):839–852. - PubMed
    1. Locke F.L., et al. Axicabtagene ciloleucel as second-line therapy for large b-cell lymphoma. N. Engl. J. Med. 2022;386(7):640–654. - PubMed

LinkOut - more resources