Skip to main content

Advertisement

SpringerLink
Log in

Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in Burkitt lymphoma

  • Original Article
  • Published:
European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Burkitt’s lymphoma (BL) is an aggressive lymphoma subtype with high 18F-FDG avidity at 18F-FDG-PET/CT, but no validated criteria for PET/CT in treatment evaluation or prediction of outcome in BL are available. The aim of our study was to investigate whether the metabolic baseline PET/CT parameters can predict treatment response and prognosis in BL.

Materials and methods

We retrospectively enrolled 65 patients who underwent baseline 18F-FDG-PET/CT, interim and end of treatment PET/CT. The PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value body weight (SUVbw), the maximum standardized uptake value lean body mass (SUVlbm), the maximum standardized uptake value body surface area (SUVbsa), lesion to liver SUVmax ratio (L-L SUV R), lesion to blood-pool SUVmax ratio (L-BP SUV R), total metabolic tumor volume (tMTV) and total lesion glycolysis (TLG). Survival curves were plotted according to the Kaplan–Meier method.

Results

At a median follow-up of 40 months, the median PFS and OS were 34 and 39 months. MTV and TLG were significantly higher in patients with partial response compared to complete response group at end of treatment, while no significant differences were found at interim. Other metabolic PET/CT parameters were not related to treatment response. MTV and TLG were demonstrated to be independent prognostic factors for both PFS and OS; instead SUVbw, SUVlbm, SUVbsa, L-L SUV R and L-BP SUV R were not related to outcome survival.

Conclusions

Metabolic tumour features (MTV and TLG) were significantly correlated with response to treatment and long-term outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  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 

  2. Bishop PC, Rao VK, Wilson WH. Burkitt’s lymphoma: molecular pathogenesis and treatment. Cancer Investig. 2000;18:574–83.

    Article  CAS  Google Scholar 

  3. Blum KA, Lozanski G, Byrd JC. Adult Burkitt leukemia and lymphoma. Blood. 2004;104:3009–20.

    Article  CAS  Google Scholar 

  4. Wästerlid T, Brown PN, Hagberg O, Hagberg H, Pedersen LM, D’Amore F, et al. Impact of chemotherapy regimen and rituximab in adult Burkitt lymphoma: a retrospective population-based study from the Nordic lymphoma group. Ann Oncol. 2013;24:1879–86.

    Article  Google Scholar 

  5. Molineux EM, Rochford R, Griffin B, Newton R, Jackson G, Menon G, et al. Burkitt’s lymphoma. Lancet. 2012;379:1234–44.

    Article  Google Scholar 

  6. Sandlund JT. Burkitt lymphoma: staging and response evaluation. Br J Hematol. 2012;156:761–5.

    Article  CAS  Google Scholar 

  7. Just PA, Fieschi C, Baillet G, Galicier L, Oksenhendler E, Moretti JL. 18F-fluorodeoxyglucose positron emission tomography/computed tomography in AIDS-related Burkitt lymphoma. AIDS Patient Care STDs. 2008;22:695–700.

    Article  Google Scholar 

  8. Zeng W, Lechowicz MJ, Winton E, Cho SM, Galt JR, Halkar R. Spectrum of FDG PET/CT findings in Burkitt lymphoma. Clin Nucl Med. 2009;4:355–8.

    Article  Google Scholar 

  9. Karantanis D, Durski JM, Lowe VJ, Nathan MA, Mullan BP. Georgiou E, et al. 18F-FDG PET and PET/CT in Burkitt’s lymphoma. Eur J Radiol. 2012;75:e68–73.

    Article  Google Scholar 

  10. Bailly C, Eugène T, Couec ML, Strullu M, Frampas E, Campion L, et al. Prognostic value and clinical impact of (18)FDG-PET in the management of children with Burkitt lymphoma after induction chemotherapy. Front Med (Lausanne). 2014;16(1):54.

    Google Scholar 

  11. Carrillo-Cruz E, Mar ın-Oyaga VA, Rodrıguez MS, Borrego-Dorado I, de la Cruz Vicente F, Quiroga Cantero E, et al. Role of 18F-FDG-PET/CT in the management of Burkitt lymphoma. Eur J Haematol. 2015;94:23–30.

    Article  CAS  Google Scholar 

  12. Wen WX, Huang JJ, Li WY, Zhang X, Xia Y, Jiang WQ, et al. Prognostic values of interim and post-therapy 18F-FDG PET/CT scanning in adult patients with Burkitt’s lymphoma. Chin J Cancer. 2015;2(34):608–13.

    Google Scholar 

  13. Albano D, Bosio G, Re A, Pagani C, Giubbini R, Bertagna F. Metabolic behaviour and prognostic value of early and end of treatment 18F-FDG PET/CT in adult burkitt lymphoma: role of Deauville and IHP criteria. Leuk Lymphoma. 2018. https://doi.org/10.1080/10428194.2018.1482541.

  14. Meignan M, Gallamini A, Haioun C, Polliack A. Report on the second international workshop on interim positron emission tomography in lymphoma held in Menton, France, 8–9 April 2010. Leuk Lymphoma. 2010;51:2171–80.

    Article  Google Scholar 

  15. Kostakoglu L, Chauvie S. Metabolic tumour volume metrics in lymphoma. Semin Nucl Med. 2018;48:50–66.

    Article  Google Scholar 

  16. Xie M, Wu K, Liu Y, Jiang Q, Xie Y. Predictive value of F-18 FDG PET/CT quantization parameters in diffuse large B cell lymphoma: a meta-analysis with 702 participants. Med Oncol. 2015;32:446.

    Article  Google Scholar 

  17. Procházka V, Klugar M, Bachanova V, Klugarová J, Tučková D, Papajík T. 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 

  18. Hoelzer D, Walewski J, Döhner H, Viardot A, Hiddemann W, Spiekermann K, et al. Improved outcome of adult Burkitt lymphoma/leukemia with rituximab and chemotherapy: report of a large prospective multicenter trial. Blood. 2014;124:3870–9.

    Article  CAS  Google Scholar 

  19. Ferreri AJ, Bruno Ventre M, Donadoni G, Cattaneo C, Fumagalli L, Foppoli M, et al. Safety and activity of a new intensive short-term chemoimmunotherapy in HIV-positive patients with Burkitt lymphoma. Br J Haematol. 2012;159:252–5.

    Article  CAS  Google Scholar 

  20. Boellaard R, Delgado-Bolton R, Oyen WJ, Giammarile F, Tatsch K, Eschner W, et al. FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0. Eur J Nucl Med Mol Imaging. 2015;42:328–54.

    Article  CAS  Google Scholar 

  21. Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32:3059–68.

    Article  Google Scholar 

  22. Barrington SF, Mikhaeel NG, Kostakoglu L, Meignan M, Hutchings M, Müeller SP, et al. Role of imaging in the staging and response assessment of lymphoma: consensus of the international conference on malignant lymphomas imaging working group. J Clin Oncol. 2014;32:3048–58.

    Article  Google Scholar 

  23. Itti E, Lin C, Dupuis J, Paone G, Capacchione D, Rahmouni A, et al. Prognostic value of interim 18F-FDG PET in patients with diffuse large B-cell lymphoma: SUV-based assessment at 4 cycles of chemotherapy. J Nucl Med. 2009;50:527–33.

    Article  Google Scholar 

  24. Casasnovas RO, Meignan M, Berriolo-Riedinger A, Bardet S, Julian A, Thieblemont C, et al. Groupe d’etude des lymphomes de l’adulte (GELA). SUVmax reduction improves early prognosis value of interim positron emission tomography scans in diffuse large B-cell lymphoma. Blood. 2011;118:37–43.

    Article  CAS  Google Scholar 

  25. 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.

    Article  Google Scholar 

  26. Dührsen U, Müller S, Hertenstein B, Thomssen H, Kotzerke J, Mesters R, et al. Positron emission tomography-guided therapy of aggressive non-Hodgkin lymphomas (PETAL): a multicenter, randomized phase III trial. J Clin Oncol. 2018;36:2024–34.

    Article  Google Scholar 

  27. Kanoun S, Rossi C, Berriolo-Riedinger A, Dygai-Cochet I, Cochet A, Humbert O, et al. Baseline metabolic tumour volume is an independent prognostic factor in Hodgkin lymphoma. Eur J Nucl Med Mol Imaging. 2014;41:1735–43.

    Article  Google Scholar 

  28. Moskowitz AJ, Schoder H, Gavane S, Thoren KL, Fleisher M, Yahalom J, et al. Prognostic significance of baseline metabolic tumor volume in relapsed and refractory Hodgkin lymphoma. Blood. 2017;130:2196–203.

    Article  CAS  Google Scholar 

  29. Sharma P, Gupta A, Patel C, Bakhshi S, Malhotra A, Kumar R. Pediatric lymphoma: metabolic tumor burden as quantitative index for treatment response evaluation. Ann Nucl Med. 2012;26:58–66.

    Article  Google Scholar 

  30. Sasanelli M, Meignan M, Haioun C, Berriolo-Riedinger A, Casasnovas RO, Biggi A, et al. Pretherapy metabolic tumour volume is an independent predictor of outcome in patients with diffuse large B-cell lymphoma. Eur J Nucl Med Mol Imaging. 2014;41:2017–22.

    Article  CAS  Google Scholar 

  31. Mikhaeel NG, Smith D, Dunn JT, Phillips M, Møller H, Fields PA, et al. Combination of baseline metabolic tumour volume and early response on PET/CT improves progression-free survival prediction in DLBCL. Eur J Nucl Med Mol Imaging. 2016;43:1209–19.

    Article  CAS  Google Scholar 

  32. Meignan M, Cottereau AS, Versari A, Chartier L, Dupuis J, Boussetta S, et al. Baseline metabolic tumor volume predicts outcome in high–tumor-burden follicular lymphoma: a pooled analysis of three multicenter studies. J Clin Oncol. 2016;34:3618–26.

    Article  Google Scholar 

  33. Weiler-Sagie M, Bushelev O, Epelbaum R, Dann EJ, Haim N, Avivi I, et al. (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med. 2010;51:25–30.

    Article  Google Scholar 

  34. Cottereau AS, Becker S, Broussais F, Casasnovas O, Kanoun S, Roques M, et al. Prognostic value of baseline total metabolic tumor volume (TMTV0) measured on FDG-PET/CT in patients with peripheral T-cell lymphoma (PTCL). Ann Oncol. 2016;27:719–24.

    Article  CAS  Google Scholar 

  35. Cottereau AS, Buvat I, Kanoun S, Versari A, Casasnovas O, Chauvie S, et al. Is there an optimal method for measuring baseline metabolic tumor volume in diffuse large B cell lymphoma? Eur J Nucl Med Mol Imaging. 2018;450:1463–4.

    Article  Google Scholar 

  36. Cottereau AS, Lanic H, Mareschal S, Meignan M, Vera P, Tilly H, et al. Molecular profile and FDG-PET/CT Total metabolic tumor volume improve risk classification at diagnosis for patients with diffuse large B-cell lymphoma. Clin Cancer Res. 2016;22:3801–9.

    Article  CAS  Google Scholar 

  37. Toledano MN, Desbordes P, Banjar A, Gardin I, Vera P, Ruminy P, et al. Combination of baseline FDG PET/CT total metabolic tumour volume and gene expression profile have a robust predictive value in patients with diffuse large B-cell lymphoma. Eur J Nucl Med Mol Imaging. 2018;45:680–8.

    Article  CAS  Google Scholar 

  38. Okuyucu K, Ozaydin S, Alagoz E, Ozgur G, Ince S, Oysul FG, et al. Prognosis estimation under the light of metabolic tumor parameteres on initial FDG-PET/CT in patients with primary extranodal lymphoma. Radiol Oncol. 2016;50:360–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Nuclear Medicine, University of Brescia and Spedali Civili Brescia, P.le Spedali Civili 1, 25123, Brescia, Italy

    Domenico Albano, Giovanni Bosio, Raffaele Giubbini & Francesco Bertagna

  2. Division of Hematology, Spedali Civili, Brescia, Italy

    Chiara Pagani, Alessandro Re & Alessandra Tucci

Authors
  1. Domenico Albano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giovanni Bosio
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chiara Pagani
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alessandro Re
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alessandra Tucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Raffaele Giubbini
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francesco Bertagna
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Domenico Albano.

Ethics declarations

Conflict of interest

The authors declare they have no conflict of interest.

Ethical approval

All 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

Informed consent was obtained from all individual participant included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Albano, D., Bosio, G., Pagani, C. et al. Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in Burkitt lymphoma. Eur J Nucl Med Mol Imaging 46, 87–96 (2019). https://doi.org/10.1007/s00259-018-4173-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00259-018-4173-2

Keywords

Search

Navigation