- Hematologic Malignancy
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Baseline Total Metabolic Tumor Volume and Total Lesion Glycolysis Measured on 18F-FDG PET-CT Predict Outcomes in T-Cell Lymphoblastic Lymphoma
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Xiaoyan Feng, Xin Wen, Ling Li, Zhenchang Sun, Xin Li, Lei Zhang, Jingjing Wu, Xiaorui Fu, Xinhua Wang, Hui Yu, Xinran Ma, Xudong Zhang, Xinli Xie, Xingmin Han, Mingzhi Zhang
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Cancer Res Treat. 2021;53(3):837-846. Published online December 2, 2020
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DOI: https://doi.org/10.4143/crt.2020.123
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 Abstract
 PDF Supplementary Material PubReader ePub
- Purpose
There is no optimal prognostic model for T-cell lymphoblastic lymphoma (T-LBL). Here, we discussed the predictive value of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured on 18F-fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) in T-LBL.
Materials and Methods
Thirty-seven treatment naïve T-LBL patients with PET-CT scans were enrolled. TMTV was obtained using the 41% maximum standardized uptake value (SUVmax) threshold method, and TLG was measured as metabolic tumor volume multiplied by the mean SUV. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier curves and compared by the log-rank test.
Results
The optimal cutoff values for SUVmax, TMTV, and TLG were 12.7, 302 cm3, and 890, respectively. A high SUVmax, TMTV, and TLG indicated a shorten PFS and OS. On multivariable analysis, TMTV ≥ 302 cm3, and central nervous system (CNS) involvement predicted inferior PFS, while high SUVmax, TLG and CNS involvement were associated with worse OS. Subsequently, we generated a risk model comprising high SUVmax, TMTV or TLG and CNS involvement, which stratified the population into three risk groups, which had significantly different median PFS of not reached, 14 months, and 7 months for low-risk group, mediate-risk group, and high-risk group, respectively (p < 0.001). Median OS were not reached, 27 months, and 13 months, respectively (p < 0.001).
Conclusion
Baseline SUVmax, TMTV, and TLG measured on PET-CT are strong predictors of worse outcome in T-LBL. A risk model integrating these three parameters with CNS involvement identifies patients at high risk of disease progression.
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Citations
Citations to this article as recorded by  - Metabolic parameters predict survival and toxicity in chimeric antigen receptor T‐cell therapy‐treated relapsed/refractory large B‐cell lymphoma
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EJNMMI Research.2021;[Epub] CrossRef
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