Anne-Ségolène Cottereau1, Tarec Christoffer El-Galaly2, Stéphanie Becker3,4, Florence Broussais5, Lars Jelstrup Petersen6, Christophe Bonnet7, John O Prior8, Hervé Tilly9, Martin Hutchings10, Olivier Casasnovas11, Michel Meignan12. 1. Nuclear Medicine Department, Tenon Hospital AP-HP, University Pierre and Marie Curie, Paris, France annesegolene.cottereau@aphp.fr. 2. Department of Hematology, Aalborg University Hospital, Aalborg, Denmark. 3. Nuclear Medicine Department, Henri Becquerel Cancer Center and Rouen University Hospital, Rouen, France. 4. QuantIF-LITIS (EA [Equipe d'Accueil] 4108), Faculty of Medicine, University of Rouen, Rouen, France. 5. Hematology Department, LYSARC CHU Lyon Pierre Bénite, Lyon, France. 6. Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark. 7. Hematology Department, C.H.U. ULg, Liège, Belgium. 8. Nuclear Medicine and Molecular Imaging Department, Lausanne University Hospital, Lausanne, Switzerland. 9. Hematology Department, Centre H. Becquerel, Rouen, France. 10. Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 11. Hematology Department, Hopital Le Bocage, C.H.U. Dijon, Dijon, France; and. 12. LYSA Imaging, Hôpitaux Universitaires Henri Mondor, Creteil, France.
Abstract
Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive non-Hodgkin lymphomas with poor outcomes on current therapy. We investigated whether response assessed with PET/CT combined with baseline total metabolic tumor volume (TMTV) could detect early relapse or refractory disease. Methods: From 7 European centers, 140 patients with nodal PTCL who underwent baseline PET/CT were selected. Forty-three had interim PET (iPET) performed after 2 cycles (iPET2), 95 had iPET performed after 3 or 4 cycles (iPET3/4), and 96 had end-of-treatment PET (eotPET). Baseline TMTV was computed with a 41% SUVmax threshold, and PET response was reported using the Deauville 5-point scale. Results: With a median of 43 mo of follow-up, the 2-y progression-free survival (PFS) and overall survival (OS) were 51% and 67%, respectively. iPET2-positive patients (Deauville score ≥ 4) had a significantly worse outcome than iPET2-negative patients (P < 0.0001, hazard ratio of 6.8 for PFS; P < 0.0001, hazard ratio of 6.6 for OS). The value of iPET3/4 was also confirmed for PFS (P < 0.0001) and OS (P < 0.0001). The 2-y PFS and OS for iPET3/4-positive (n = 28) and iPET3/4-negative (n = 67) patients were 16% and 32% versus 75% and 85%, respectively. The eotPET results also reflected patient outcome. A model combining TMTV and iPET3/4 stratified the population into distinct risk groups (TMTV ≤ 230 cm3 and iPET3/4-negative [2-y PFS/OS, 79%/85%]; TMTV > 230 cm3 and iPET3/4-negative [59%/84%]; TMTV ≤ 230 cm3 and iPET3/4-positive [42%/50%]; TMTV > 230 cm3 and iPET3/4-positive [0%/18%]). Conclusion: iPET response is predictive of outcome and allows early detection of high-risk PTCL patients. Combining iPET with TMTV improves risk stratification in individual patients.
Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive non-Hodgkin lymphomas with poor outcomes on current therapy. We investigated whether response assessed with PET/CT combined with baseline total metabolic tumor volume (TMTV) could detect early relapse or refractory disease. Methods: From 7 European centers, 140 patients with nodal PTCL who underwent baseline PET/CT were selected. Forty-three had interim PET (iPET) performed after 2 cycles (iPET2), 95 had iPET performed after 3 or 4 cycles (iPET3/4), and 96 had end-of-treatment PET (eotPET). Baseline TMTV was computed with a 41% SUVmax threshold, and PET response was reported using the Deauville 5-point scale. Results: With a median of 43 mo of follow-up, the 2-y progression-free survival (PFS) and overall survival (OS) were 51% and 67%, respectively. iPET2-positive patients (Deauville score ≥ 4) had a significantly worse outcome than iPET2-negative patients (P < 0.0001, hazard ratio of 6.8 for PFS; P < 0.0001, hazard ratio of 6.6 for OS). The value of iPET3/4 was also confirmed for PFS (P < 0.0001) and OS (P < 0.0001). The 2-y PFS and OS for iPET3/4-positive (n = 28) and iPET3/4-negative (n = 67) patients were 16% and 32% versus 75% and 85%, respectively. The eotPET results also reflected patient outcome. A model combining TMTV and iPET3/4 stratified the population into distinct risk groups (TMTV ≤ 230 cm3 and iPET3/4-negative [2-y PFS/OS, 79%/85%]; TMTV > 230 cm3 and iPET3/4-negative [59%/84%]; TMTV ≤ 230 cm3 and iPET3/4-positive [42%/50%]; TMTV > 230 cm3 and iPET3/4-positive [0%/18%]). Conclusion:iPET response is predictive of outcome and allows early detection of high-risk PTCL patients. Combining iPET with TMTV improves risk stratification in individual patients.
Authors: Amy J Weisman; Minnie W Kieler; Scott B Perlman; Martin Hutchings; Robert Jeraj; Lale Kostakoglu; Tyler J Bradshaw Journal: Radiol Artif Intell Date: 2020-09-02