Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in mantle cell lymphoma
Mantle cell lymphoma (MCL) is an aggressive lymphoma sub-type with poor prognosis and high 18F-FDG avidity at PET/CT; nowadays, no validated criteria for PET/CT in treatment response evaluation and prediction of outcome are present. The aim of study was to investigate whether the metabolic PET/CT features may predict treatment evaluation and prognosis in MCL.
We retrospectively enrolled 87 patients who underwent baseline 18F-FDG PET/CT and 85 end-of-treatment (eot) PET/CT. The baseline PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value body weight (SUVbw), lean body mass (SUVlbm), body surface area (SUVbsa), lesion-to-liver SUVmax ratio (L-L SUV R), lesion-to-blood pool SUVmax ratio (L-BP SUV R), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). EotPET/CT was visually interpreted according to the criteria of the Deauville 5-point scale (DC). Survival curves were plotted according to the Kaplan–Meier method.
At a median follow-up of 40 months, relapse/progression occurred in 47 and death in 23 patients. Median PFS and OS were 30 and 41 months. Baseline MTV and TLG were significantly higher in patients with progressive metabolic response compared to complete/partial response group. EotPET/CT results using DC significantly correlated with PFS, not with OS. MTV and TLG were demonstrated to be independent prognostic factors for PFS; instead the other metabolic parameters were not related to outcome survival. Considering OS, no variable was significantly associated.
EotPET/CT results (using DC), MTV and TLG were significantly correlated with response to treatment and PFS.
KeywordsMantle cell lymphoma 18F-FDG PET/CT MTV TLG Prognosis
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All the procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.
Informed consent was obtained from all the individual participants included in the study.
- 1.Swerdlow SH, Campo E, Harris NL, et al. World health organization classification of tumours of haematopoietic and lymphoid tissues. Lyon: IARC Press; 2008.Google Scholar
- 8.Gill S, Wolf M, Miles Prince H, et al. 18F Fluorodeoxyglucose positron emission tomography scanning for staging, response assessment, and disease surveillance in patients with Mantle cell lymphoma. Clin Lymphoma Myeloma Leuk. 2008;8:158–65.Google Scholar
- 24.Garcia M, Romaguera JE, Inamdar KV, et al. Proliferation predicts failure-free survival in mantle cell lymphoma patients treated with rituximab plus hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with rituximab plus high-dose methotrexate and cytarabine. Cancer. 2009;115:1041–8.CrossRefGoogle Scholar
- 29.Klener P, Fronkova E, Belada D, et al. Alternating R-CHOP and R-cytarabine is a safe and effective regimen for transplant-ineligible patients with a newly diagnosed mantle cell lymphoma. HematolOncol. 2018;36:110–5.Google Scholar
- 35.Procházka V, Klugar M, Bachanova V, et al. Comparing the accuracy of quantitative versus qualitative analyses of interim PET to prognosticate Hodgkin lymphoma: a systematic review protocol of diagnostic test accuracy. BMJ Open. 2016;5:6.Google Scholar