Prognostic value of [18F]FDG PET/CT in follicular lymphoma.

A Díaz Silván, D Cabello García, L F Otón Sánchez
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Abstract

Objective: To determine the prognostic value of [18F]FDG PET/CT in follicular lymphoma (FL) patients in our routine clinical practice.

Material and methods: Retrospective study of FL patients assessed with PET/CT in our centre from 01/06/2008 to 01/06/2020. This study aimed to investigate the prognostic value of quantitative parameters (MTV, TLG, ΔSUV max) and qualitative criteria (Lugano classification), and its relationships with progression-free survival (PFS) and overall survival (OS).

Results: Among patients with available staging PET/CT, the 5-year OS was 90.4% for those with lower MTV and 89.7% for those with higher MTV (p = 0.3). The PFS was 77.6% for those with lower MTV and 53.2% for those with higher MTV (p = 0.001). TLG yielded statistically similar results. A ΔSUV max ≥ 66% was associated with higher OS and PFS at 5 years, at both interim and final PET/CT studies (iPET and fPET). The 5-year OS for patients with complete metabolic response was 86.3% in iPET and 89.0% in fPET, compared to 84.1% and 79.0%, respectively, for those positive in iPET (p = 0.3) and fPET (p = 0.1). The 5-year PFS for patients with complete metabolic response was 76.9% in iPET and 73.1% in fPET, compared to 58.7% and 62.2%, respectively, for those positive in iPET (p = 0.04) and fPET (p = 0.09).

Conclusions: PET/CT is valuable as a prognostic factor in FL, both during staging (providing parameters with independent prognostic value such as MTV and TLG) and during and after treatment (as it correlates with survival).

[18F]FDG PET/CT对滤泡性淋巴瘤的预后价值。
目的:探讨[18F]FDG PET/CT对滤泡性淋巴瘤(follicular lymphoma, FL)患者预后的临床价值。材料与方法:回顾性研究本中心2008年6月1日至2020年6月1日经PET/CT检查的FL患者。本研究旨在探讨定量参数(MTV、TLG、ΔSUV max)和定性标准(Lugano分类)的预后价值,及其与无进展生存期(PFS)和总生存期(OS)的关系。结果:在可分期的PET/CT患者中,MTV低组5年OS为90.4%,MTV高组为89.7% (p = 0.3)。低MTV组的PFS为77.6%,高MTV组为53.2% (p = 0.001)。TLG产生了统计上相似的结果。在中期和最终PET/CT研究(iPET和fPET)中,ΔSUV max≥66%与5年的OS和PFS较高相关。iPET和fPET完全代谢应答患者的5年OS分别为86.3%和89.0%,而iPET和fPET阳性患者的5年OS分别为84.1%和79.0% (p = 0.3)和p = 0.1)。iPET和fPET完全代谢反应患者的5年PFS分别为76.9%和73.1%,而iPET和fPET阳性患者的5年PFS分别为58.7%和62.2% (p = 0.04)和p = 0.09。结论:PET/CT作为FL的预后因素是有价值的,无论是在分期期间(提供具有独立预后价值的参数,如MTV和TLG),还是在治疗期间和治疗后(因为它与生存相关)。
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