Prognostic impact of metabolic tumor volume using the SUV4.0 segmentation threshold in 1,960 lymphoma patients from prospective LYSA trials

IF 8.6 1区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Nuclear Medicine and Molecular Imaging Pub Date : 2025-03-20 DOI:10.1007/s00259-025-07176-4

Solène Malmon, Mad-Helenie Elsensohn, Catherine Thieblemont, Franck Morschhauser, Olivier Casasnovas, Marc André, Steven Le Gouill, Yassine Al Tabaa, Paul Bland Durand, Clement Bailly, Veronique Edeline, Lavinia Vija, Laetitia Vercellino, Romain Ricci, Salim Kanoun, Anne-Ségolène Cottereau

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Abstract

Purpose

This study compared the prognostic value of total metabolic tumor volume (TMTV) in lymphoma measured with the recently proposed SUV4.0 segmentation threshold versus the 41% SUVmax across LYSA trials and its impact on intensity and dissemination PET features.

Methods

A total of 1960 baseline PET/CT scans of Diffuse Large B cell lymphoma (DLBCL), follicular lymphoma (FL) and Hodgkin lymphoma (HL) patients were collected. After a semi-automatic preselection of region of interest, two different segmentation threshold were applied: 41% SUVmax (TMTV_41%) and SUV > 4.0 (TMTV_4.0).

Results

The correlation between TMTV_4.0 and TMTV_41% was ρ = 0.90 for DLBCL, ρ = 0.65 for FL and ρ = 0.60 for HL. For SUVmax, SUVpeak, Dmax and Dbulk features, a strong correlation was observed with ρ > 0.95 whatever the lymphoma subtypes. The predictability of TMTV was high and comparable for the two methods with superimposable confidence intervals for the three subtypes. At the 90th percentile TMTV value, the predicted 7-year PFS was 51.13% with TMTV_4.0 vs. 49.7% with TMTV_41% for DLBCL patients, 45.5% vs. 39.8% for FL patients, and 82.6% vs. 80.5% for HL patients. A minority of patients showed a predicted PFS deviation > 10% between the two methods: 2.33% in DLBCL, 6.51% in FL and 1% in HL.

Conclusion

TMTV measured with the SUV4.0 threshold provides a comparable PFS prediction than the 41%SUVmax method supporting its routine adoption particularly in the diffuse large B cell lymphoma subtype.

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来源期刊

European Journal of Nuclear Medicine and Molecular Imaging 医学-核医学

CiteScore

15.60

自引率

9.90%

发文量

392

审稿时长

3 months

期刊介绍： The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.