Is there an optimal method for measuring baseline metabolic tumor volume in diffuse large B cell lymphoma?
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Given the absence of a recognized gold standard for assessing the metabolic tumor volume (MTV) in FDG PET, it is important to discuss the strengths and weaknesses of the different methods used in DLBCL.
In their retrospective series of 147 patients, Ylyas et al.  tested three different fixed thresholding methods: SUV ≥ 2.5, ≥ 41% of the SUVmax and a liver uptake dependent threshold as suggested in PERCIST. They confirmed the strong prognostic value of baseline MTV, regardless of the method used, consistent with previous findings [2, 3]. These results deserve further comments.
The median MTV reported in this study with the 41% SUVmax method is surprisingly low (165 cm3) with a large difference with the 2.5 method (~590 cm3). Although the population included 70% of advanced stage patients, their median is much lower than values reported in previous studies employing 41% SUVmax method in DLBCL, with medians of 258 cm3 , 315 cm3 , 320 cm3 , and 373 cm3 . Using a...
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Conflict of interest
The authors declare that they have no conflict of interest.
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