BACKGROUND: We evaluated the role of [18F]FDG PET/CT in tumor response assessment and prognosis of Primary Extranodal Lymphoma (PEL) patients. METHODS: We examined retrospectively, 56 PEL patients: 31 with aggressive diffuse large B cell lymphoma (DLBCL) and 25 with indolent lymphoma (20 mucosa-associated lymphoid tissue lymphoma-MALT and 5 follicular lymphoma). All patients had undergone [18F]FDG PET/CT at diagnosis (PET-I) and 50 of them also after therapy (PET-II). Moreover, 52 patients were subjected to a mean follow-up period of 76 months. RESULTS: PET-I was positive in 50 (89%) patients (mean SUVmax 10.3±6.7). In the assessment of tumor response, according to Lugano classification, 45 patients showed complete metabolic response (CMR), 4 patients had partial metabolic response (PMR) and 1 had progressive metabolic disease (PMD). Based on 66% ΔSUVmax cut-off, among CMR patients, 41 showed a ΔSUVmax>66% whereas among nonresponders, 4 patients showed a ΔSUVmax<66%. At follow-up, univariate analysis showed that age, performance status, prognostic index, ΔSUVmax and Lugano classification predicted Progression Free Survival (PFS) (p<0.05), while, performance status, prognostic index, ΔSUVmax and Lugano classification predicted Overall Survival (OS) (p<0.05). At multivariate analysis only Lugano classification was retained in the model for prediction of both PFS (p<0.05) and OS (p<0.05). By Kaplan-Meier analysis and log- rank testing both PFS and OS were significantly better in patients in CMR as compared to patients in PMR or PMD according to Lugano classification (p<0.01). CONCLUSIONS: [18F]FDG PET/CT represents a useful tool in the detection of disease response and in the evaluation of outcome in PEL patients.
2-deoxy-2-(18F)fluoro-D-glucose positron emission tomography/computed tomography in primary extranodal lymphomas: treatment response evaluation and prognosis
Selleri C;Pace L
2020-01-01
Abstract
BACKGROUND: We evaluated the role of [18F]FDG PET/CT in tumor response assessment and prognosis of Primary Extranodal Lymphoma (PEL) patients. METHODS: We examined retrospectively, 56 PEL patients: 31 with aggressive diffuse large B cell lymphoma (DLBCL) and 25 with indolent lymphoma (20 mucosa-associated lymphoid tissue lymphoma-MALT and 5 follicular lymphoma). All patients had undergone [18F]FDG PET/CT at diagnosis (PET-I) and 50 of them also after therapy (PET-II). Moreover, 52 patients were subjected to a mean follow-up period of 76 months. RESULTS: PET-I was positive in 50 (89%) patients (mean SUVmax 10.3±6.7). In the assessment of tumor response, according to Lugano classification, 45 patients showed complete metabolic response (CMR), 4 patients had partial metabolic response (PMR) and 1 had progressive metabolic disease (PMD). Based on 66% ΔSUVmax cut-off, among CMR patients, 41 showed a ΔSUVmax>66% whereas among nonresponders, 4 patients showed a ΔSUVmax<66%. At follow-up, univariate analysis showed that age, performance status, prognostic index, ΔSUVmax and Lugano classification predicted Progression Free Survival (PFS) (p<0.05), while, performance status, prognostic index, ΔSUVmax and Lugano classification predicted Overall Survival (OS) (p<0.05). At multivariate analysis only Lugano classification was retained in the model for prediction of both PFS (p<0.05) and OS (p<0.05). By Kaplan-Meier analysis and log- rank testing both PFS and OS were significantly better in patients in CMR as compared to patients in PMR or PMD according to Lugano classification (p<0.01). CONCLUSIONS: [18F]FDG PET/CT represents a useful tool in the detection of disease response and in the evaluation of outcome in PEL patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
