Comparison of therapeutic evaluation criteria in FDG-PET/CT in patients with diffuse large-cell B-cell lymphoma: Prognostic impact of tumor/liver ratio.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2019
Historique:
received: 23 10 2018
accepted: 17 01 2019
entrez: 8 2 2019
pubmed: 8 2 2019
medline: 13 11 2019
Statut: epublish

Résumé

The study objective was to compare the prognostic value of interim and end-of-treatment FDG PET/CT using five therapeutic evaluation criteria in patients with diffuse large B cell lymphoma (DLBCL). 181 patients were retrospectively analysed. All patients underwent FDG-PET at baseline and after four cycles (iPET4) of first-line chemotherapy and 165 at the end-of-treatment (PET-eot). Ratio Deauville score (rDS) (SUVmax-target residual lesion/SUVmax-liver) was measured in iPET4 and PET-eot, and its optimal threshold was determined using receiver operating characteristic (ROC) curve analysis. Deauville score (DS) (iPET4 and PET-eot), ΔSUVmax, ΔSUVmax determined according to Menton 2011 criteria (ΔSUVmax+DS) and ΔSUVmax+rDS were also evaluated (iPET4 only). Median follow-up was 44 months. ROC analysis revealed the optimal cut-off value was 1.4-fold of SUVmax-liver on iPET4 and PET-eot. On iPET4, positive predictive value (PPV) of rDS was significantly better than DS: 81.58% vs. 67.79%. In univariate analysis, the five interpretation methods were statistically significant (p<0.0001 for progression-free survival [PFS] and overall survival [OS]). In multivariate analysis, only rDS was an independent prognostic factor (p = 0.0002 and p<0.0001 for PFS and OS, respectively). On PET-eot, similarly, the two therapeutic evaluation criteria analysed (rDS and DS) were statistically significant at the univariate level (p<0.0001). rDS was the only significant prognostic factor in multivariate analysis (p<0.0001). PPV and accuracy of rDS were also better than DS. rDS with a tumor/liver ratio of 1.4 is a robust prognostic factor in patients with DLBCL on iPET4 and PET-eot.

Identifiants

pubmed: 30730936
doi: 10.1371/journal.pone.0211649
pii: PONE-D-18-30517
pmc: PMC6366736
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0211649

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Mathieu N Toledano (MN)

Nuclear Medicine Department, Henri Becquerel Cancer Center, Rouen, France.
QuantIF-LITIS (EA 4108-FR CNRS 3638), Faculty of Medicine, University of Rouen, Rouen, France.

Pierre Vera (P)

Nuclear Medicine Department, Henri Becquerel Cancer Center, Rouen, France.
QuantIF-LITIS (EA 4108-FR CNRS 3638), Faculty of Medicine, University of Rouen, Rouen, France.

Hervé Tilly (H)

INSERM U1245, Centre Henri Becquerel, Rouen, France.
Hematology department, Centre Henri Becquerel, Rouen, France.

Fabrice Jardin (F)

INSERM U1245, Centre Henri Becquerel, Rouen, France.
Hematology department, Centre Henri Becquerel, Rouen, France.

Stéphanie Becker (S)

Nuclear Medicine Department, Henri Becquerel Cancer Center, Rouen, France.
QuantIF-LITIS (EA 4108-FR CNRS 3638), Faculty of Medicine, University of Rouen, Rouen, France.

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Classifications MeSH