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Pretherapy metabolic tumour volume is an independent predictor of outcome in patients with diffuse large B-cell lymphoma

  • Myriam Sasanelli
  • Michel Meignan
  • Corinne Haioun
  • Alina Berriolo-Riedinger
  • René-Olivier Casasnovas
  • Alberto Biggi
  • Andrea Gallamini
  • Barry A. Siegel
  • Amanda F. Cashen
  • Pierre Véra
  • Hervé Tilly
  • Annibale Versari
  • Emmanuel IttiEmail author
Original Article

Abstract

Purpose

We investigated the prognostic value of total metabolic tumour volume (TMTV) in diffuse large B-cell lymphoma (DLBCL).

Methods

TMTV was measured in 114 patients with newly diagnosed DLBCL who underwent 18F-FDG PET/CT at baseline before immunochemotherapy. TMTV was computed by summing the volumes of all lymphomatous lesions after applying the local SUVmax threshold of 41 % using semiautomatic software. Prognostic value was assessed by Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS).

Results

Median follow-up was 39 months. Average pretherapy TMTV was 509 ± 568 cm3. The 3-year estimates of PFS were 77 % in the low metabolic burden group (TMTV ≤550 cm3) and 60 % in the high metabolic burden group (TMTV >550 cm3, p = 0.04), and prediction of OS was even better (87 % vs. 60 %, p = 0.0003). Cox regression showed independence of TMTV for OS prediction (p = 0.002) compared with other pretherapy indices of tumour burden, such as tumour bulk and the International Prognostic Index.

Conclusion

Pretherapy TMTV is an independent predictor of outcome in patients with DLBCL.

Key words

PET/CT Diffuse large B-cell lymphoma Metabolic tumour volume Total lesion glycolysis Outcome prediction 

Notes

Conflicts of interest

None.

References

  1. 1.
    Hutchings M, Barrington SF. PET/CT for therapy response assessment in lymphoma. J Nucl Med. 2009;50 Suppl 1:21S–30S.PubMedCrossRefGoogle Scholar
  2. 2.
    Bari A, Marcheselli L, Sacchi S, Marcheselli R, Pozzi S, Ferri P, et al. Prognostic models for diffuse large B-cell lymphoma in the rituximab era: a never-ending story. Ann Oncol. 2010;21:1486–91.PubMedCrossRefGoogle Scholar
  3. 3.
    Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P, et al. The revised international prognostic index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007;109:1857–61.PubMedCrossRefGoogle Scholar
  4. 4.
    Copie-Bergman C, Gaulard P, Leroy K, Briere J, Baia M, Jais JP, et al. Immuno-fluorescence in situ hybridization index predicts survival in patients with diffuse large B-cell lymphoma treated with R-CHOP: a GELA study. J Clin Oncol. 2009;27:5573–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Sehn LH, Scott DW, Chhanabhai M, Berry B, Ruskova A, Berkahn L, et al. Impact of concordant and discordant bone marrow involvement on outcome in diffuse large B-cell lymphoma treated with R-CHOP. J Clin Oncol. 2011;29:1452–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Pfreundschuh M, Ho AD, Cavallin-Stahl E, Wolf M, Pettengell R, Vasova I, et al. Prognostic significance of maximum tumour (bulk) diameter in young patients with good-prognosis diffuse large-B-cell lymphoma treated with CHOP-like chemotherapy with or without rituximab: an exploratory analysis of the MabThera International Trial Group (MInT) study. Lancet Oncol. 2008;9:435–44.PubMedCrossRefGoogle Scholar
  7. 7.
    Paone G, Itti E, Haioun C, Gaulard P, Dupuis J, Lin C, et al. Bone marrow involvement in diffuse large B-cell lymphoma: correlation between FDG-PET uptake and type of cellular infiltrate. Eur J Nucl Med Mol Imaging. 2009;36:745–50.PubMedCrossRefGoogle Scholar
  8. 8.
    Meignan MA, Sasanelli MC, Casasnovas RO, Luminari S, Fioroni F, Coriani C, et al. Metabolic tumour volumes measured at staging in lymphoma: methodological evaluation on phantom experiments and patients. Eur J Nucl Med Mol Imaging. 2014;41:1113–22.PubMedCrossRefGoogle Scholar
  9. 9.
    Itti E, Meignan M, Berriolo-Riedinger A, Biggi A, Cashen AF, Vera 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.PubMedCrossRefGoogle Scholar
  10. 10.
    Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002;346:235–42.PubMedCrossRefGoogle Scholar
  11. 11.
    Gobbi PG, Bassi E, Bergonzi M, Merli F, Coriani C, Iannitto E, et al. Tumour burden predicts treatment resistance in patients with early unfavourable or advanced stage Hodgkin lymphoma treated with ABVD and radiotherapy. Hematol Oncol. 2012;30:194–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Hyun SH, Ahn HK, Kim H, Ahn MJ, Park K, Ahn YC, et al. Volume-based assessment by (18)F-FDG PET/CT predicts survival in patients with stage III non-small-cell lung cancer. Eur J Nucl Med Mol Imaging. 2014;41:50–8.PubMedCrossRefGoogle Scholar
  13. 13.
    Park GC, Kim JS, Roh JL, Choi SH, Nam SY, Kim SY. Prognostic value of metabolic tumor volume measured by 18F-FDG PET/CT in advanced-stage squamous cell carcinoma of the larynx and hypopharynx. Ann Oncol. 2013;24:208–14.PubMedCrossRefGoogle Scholar
  14. 14.
    Song MK, Chung JS, Shin HJ, Lee SM, Lee SE, Lee HS, et al. Clinical significance of metabolic tumor volume by PET/CT in stages II and III of diffuse large B cell lymphoma without extranodal site involvement. Ann Hematol. 2012;91:697–703.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Esfahani SA, Heidari P, Halpern EF, Hochberg EP, Palmer EL, Mahmood U. Baseline total lesion glycolysis measured with (18)F-FDG PET/CT as a predictor of progression-free survival in diffuse large B-cell lymphoma: a pilot study. Am J Nucl Med Mol Imaging. 2013;3:272–81.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Freudenberg LS, Antoch G, Schutt P, Beyer T, Jentzen W, Muller SP, et al. FDG-PET/CT in re-staging of patients with lymphoma. Eur J Nucl Med Mol Imaging. 2004;31:325–9.PubMedCrossRefGoogle Scholar
  17. 17.
    Boellaard R, O’Doherty MJ, Weber WA, Mottaghy FM, Lonsdale MN, Stroobants SG, et al. FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0. Eur J Nucl Med Mol Imaging. 2010;37:181–200.PubMedCrossRefPubMedCentralGoogle Scholar
  18. 18.
    Boellaard R. Standards for PET image acquisition and quantitative data analysis. J Nucl Med. 2009;50 Suppl 1:11S–20S.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Myriam Sasanelli
    • 1
  • Michel Meignan
    • 1
  • Corinne Haioun
    • 1
  • Alina Berriolo-Riedinger
    • 2
  • René-Olivier Casasnovas
    • 2
  • Alberto Biggi
    • 3
  • Andrea Gallamini
    • 3
  • Barry A. Siegel
    • 4
  • Amanda F. Cashen
    • 4
  • Pierre Véra
    • 5
  • Hervé Tilly
    • 5
  • Annibale Versari
    • 6
  • Emmanuel Itti
    • 1
    Email author
  1. 1.Nuclear Medicine and Lymphoid Malignancies Unit, Henri Mondor HospitalParis-Est UniversityCréteilFrance
  2. 2.Nuclear Medicine and Hematology, Georges-François Leclerc Center, Le Bocage HospitalDijonFrance
  3. 3.Nuclear Medicine and Hematology, Santa Croce e Carle HospitalCuneoItaly
  4. 4.Nuclear Medicine and Oncology, Siteman Cancer CenterWashington University School of MedicineSt. LouisUSA
  5. 5.Nuclear Medicine and Hematology, Henri Becquerel CenterRouenFrance
  6. 6.Nuclear Medicine, Santa Maria Nuova Hospital-IRCCSReggio EmiliaItaly

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