SUVmax reduction improves early prognosis value of interim positron emission tomography scans in diffuse large B-cell lymphoma
René-Olivier Casasnovas, Michel Meignan, Alina Berriolo-Riedinger, Stéphane Bardet, Anne Julian, Catherine Thieblemont, Pierre Vera, Serge Bologna, Josette Brière, Jean-Philippe Jais, Corinne Haioun, Bertrand Coiffier, Franck Morschhauser, Groupe d'étude des lymphomes de l'adulte (GELA), René-Olivier Casasnovas, Michel Meignan, Alina Berriolo-Riedinger, Stéphane Bardet, Anne Julian, Catherine Thieblemont, Pierre Vera, Serge Bologna, Josette Brière, Jean-Philippe Jais, Corinne Haioun, Bertrand Coiffier, Franck Morschhauser, Groupe d'étude des lymphomes de l'adulte (GELA)
Abstract
The prognostic value of interim positron emission tomography (PET) interpreted according to visual criteria is a matter of debate in diffuse large B-cell lymphoma (DLBCL). Maximal standardized uptake value reduction (ΔSUVmax) may better predict outcome. To compare the prognostic value of both methods, we analyzed PET done at baseline (PET0) and after 2 (PET2) and 4 (PET4) cycles in 85 patients with high-risk DLBCL enrolled on a prospective multicenter trial. All images were centrally reviewed and interpreted visually according to the International Harmonization Project criteria and by computing ΔSUVmax between PET0 and PET2 (ΔSUVmaxPET0-2) or PET4 (ΔSUVmaxPET0-4). Optimal cutoff to predict progression or death was 66% for ΔSUVmaxPET0-2 and 70% for ΔSUVmaxPET0-4. Outcomes did not differ significantly whether PET2 and PET4 were visually positive or negative. Inversely, ΔSUVmaxPET0-2 analysis (> 66% vs ≤ 66%) identified patients with significantly different 2-year progression-free survival (77% vs 57%; P = .0282) and overall survival (93% vs 60%; P < .0001). ΔSUVmaxPET0-4 analysis (> 70% vs ≤ 70%) seemed even more predictive for 2-year progression-free survival (83 vs 40%; P < .0001) and overall survival (94% vs 50%; P < .0001). ΔSUVmax analysis of sequential interim PET is feasible for high-risk DLBCL and better predicts outcome than visual analysis. The trial was registered at https://ichgcp.net/clinical-trials-registry/NCT00498043" title="See in ClinicalTrials.gov">NCT00498043.
Source: PubMed