Ruimin Wang1, Baixuan Xu1, Changbin Liu1, Zhiwei Guan1, Jinming Zhang1, Fei Li2, Lu Sun3, Haiyan Zhu2. 1. 1 Department of Nuclear Medicine, PLA General Hospital , Beijing , China. 2. 2 Department of Hematology, PLA General Hospital , Beijing , China. 3. 3 Department of Pathology, PLA General Hospital , Beijing , China.
Abstract
OBJECTIVE: : To examine the prognostic value of fluorodeoxyglucose (FDG) and fluorothymidine (FLT) interim positron emission tomography/CT (PET/CT) for diffuse large B-cell lymphoma (DLBCL). METHODS: : 44 patients with newly diagnosed DLBCL underwent both fluorine 18 FDG (18F-FDG) and 18F-FLT PET/CT scans at baseline and after two cycles of a rituximab-containing chemotherapy regimen. Maximum standard uptake values (SUVmax) and changes in SUV (ΔSUV) were calculated for both tracers for the predominant lesion of each patient, for prediction of progression-free survival (PFS) and overall survival (OS). RESULTS: : The median follow-up period was 71 months. Receiver operating characteristic (ROC) analysis indicated that the best ΔSUV cut-off values for FDG (ΔSUVFDG) and FLT (ΔSUVFLT) were 79 and 76%, respectively. A ΔSUVFLT cut-off of 76% had the highest significance for prediction of PFS (p = 0.003) and OS (p = 0009), with sensitivity, specificity, and accuracy of 80.0, 85.7, and 81.8% respectively in response assessment. CONCLUSION: : Interim FLT PET/CT had higher specificity and accuracy than standard FDG PET/CT-based interpretation. ADVANCES IN KNOWLEDGE:: This study demonstrated that interim FLT PET/CT had higher accuracy than standardized FDG-based interpretation for therapeutic response assessment in DLBCL. FLT had the advantage of potentially reducing false positive of interim FDG PET/CT.
OBJECTIVE: : To examine the prognostic value of fluorodeoxyglucose (FDG) and fluorothymidine (FLT) interim positron emission tomography/CT (PET/CT) for diffuse large B-cell lymphoma (DLBCL). METHODS: : 44 patients with newly diagnosed DLBCL underwent both fluorine 18 FDG (18F-FDG) and 18F-FLT PET/CT scans at baseline and after two cycles of a rituximab-containing chemotherapy regimen. Maximum standard uptake values (SUVmax) and changes in SUV (ΔSUV) were calculated for both tracers for the predominant lesion of each patient, for prediction of progression-free survival (PFS) and overall survival (OS). RESULTS: : The median follow-up period was 71 months. Receiver operating characteristic (ROC) analysis indicated that the best ΔSUV cut-off values for FDG (ΔSUVFDG) and FLT (ΔSUVFLT) were 79 and 76%, respectively. A ΔSUVFLT cut-off of 76% had the highest significance for prediction of PFS (p = 0.003) and OS (p = 0009), with sensitivity, specificity, and accuracy of 80.0, 85.7, and 81.8% respectively in response assessment. CONCLUSION: : Interim FLT PET/CT had higher specificity and accuracy than standard FDG PET/CT-based interpretation. ADVANCES IN KNOWLEDGE:: This study demonstrated that interim FLT PET/CT had higher accuracy than standardized FDG-based interpretation for therapeutic response assessment in DLBCL. FLT had the advantage of potentially reducing false positive of interim FDG PET/CT.
Authors: R Andrew Harkins; Andres Chang; Sharvil P Patel; Michelle J Lee; Jordan S Goldstein; Selin Merdan; Christopher R Flowers; Jean L Koff Journal: Expert Rev Hematol Date: 2019-09-12 Impact factor: 2.929