Fan Ge, Tingting Wu, Xinyue Yang, Mengye Peng, Chen Yang, Kezheng Wang
{"title":"基于18F-FDG PET/CT基线代谢参数预测弥漫性大b细胞淋巴瘤异质性和复发的可行性分析","authors":"Fan Ge, Tingting Wu, Xinyue Yang, Mengye Peng, Chen Yang, Kezheng Wang","doi":"10.1007/s00277-025-06409-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the predictive value of intra-tumoral <sup>18</sup>F-FDG metabolic heterogeneity in patients with diffuse large B cell lymphoma (DLBCL) in terms of survival.</p><p><strong>Methods: </strong>We retrospectively included 245 patients with DLBCL who underwent <sup>18</sup>F-FDG PET/CT prior to treatment and analyzed using total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) as metabolic volume parameters. The linear regression slopes of TMTV and TLG were calculated according to different percentages of SUV thresholds (i.e., 40%, 50%, 60%, 70%, and 80%), respectively, defined as Heterogeneity Factor-1 (HF1) and Heterogeneity Factor-2 (HF2). These indices of heterogeneity were used to predict progression-free survival (PFS). Based on the results of the Cox proportional hazards model, we constructed a multi-parameter prediction model and evaluated the model in the training and validation cohorts by calibration curve, consistency index (C-index) and decision curve analysis (DCA).</p><p><strong>Results: </strong>Clinicopathological and PET/CT data from 245 patients were reviewed. 153 patients (62.4%) experienced relapse after treatment. Comparing relapsed and non-relapse patients, all <sup>18</sup>F-FDG PET/CT parameters and heterogeneity index showed significant differences. There were significant differences in survival risk stratification according to HF1 and HF2 cut-off classifications (P < 0.0001). In multivariate Cox regression analysis, SUVmax (P < 0.0001), TLG (P < 0.0001), HF1 (P = 0.004), and HF2 (P < 0.0001) showed significant results. Among the clinicopathological parameters, IPI (P = 0.027) and Size (P < 0.0001) were selected as important parameters.</p><p><strong>Conclusions: </strong>HF1 and HF2 obtained by the linear regression slope of MTV and TLG may be a novel and useful prognostic marker in DLBCL, which can achieve survival-risk stratification of patients. In addition, multiparametric models have the potential to effectively predict the risk of recurrence in patients.</p>","PeriodicalId":8068,"journal":{"name":"Annals of Hematology","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Feasibility analysis of metabolic parameters based on baseline <sup>18</sup>F-FDG PET/CT to predict heterogeneity and recurrence of diffuse large B-cell lymphoma.\",\"authors\":\"Fan Ge, Tingting Wu, Xinyue Yang, Mengye Peng, Chen Yang, Kezheng Wang\",\"doi\":\"10.1007/s00277-025-06409-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to evaluate the predictive value of intra-tumoral <sup>18</sup>F-FDG metabolic heterogeneity in patients with diffuse large B cell lymphoma (DLBCL) in terms of survival.</p><p><strong>Methods: </strong>We retrospectively included 245 patients with DLBCL who underwent <sup>18</sup>F-FDG PET/CT prior to treatment and analyzed using total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) as metabolic volume parameters. The linear regression slopes of TMTV and TLG were calculated according to different percentages of SUV thresholds (i.e., 40%, 50%, 60%, 70%, and 80%), respectively, defined as Heterogeneity Factor-1 (HF1) and Heterogeneity Factor-2 (HF2). These indices of heterogeneity were used to predict progression-free survival (PFS). Based on the results of the Cox proportional hazards model, we constructed a multi-parameter prediction model and evaluated the model in the training and validation cohorts by calibration curve, consistency index (C-index) and decision curve analysis (DCA).</p><p><strong>Results: </strong>Clinicopathological and PET/CT data from 245 patients were reviewed. 153 patients (62.4%) experienced relapse after treatment. Comparing relapsed and non-relapse patients, all <sup>18</sup>F-FDG PET/CT parameters and heterogeneity index showed significant differences. There were significant differences in survival risk stratification according to HF1 and HF2 cut-off classifications (P < 0.0001). In multivariate Cox regression analysis, SUVmax (P < 0.0001), TLG (P < 0.0001), HF1 (P = 0.004), and HF2 (P < 0.0001) showed significant results. Among the clinicopathological parameters, IPI (P = 0.027) and Size (P < 0.0001) were selected as important parameters.</p><p><strong>Conclusions: </strong>HF1 and HF2 obtained by the linear regression slope of MTV and TLG may be a novel and useful prognostic marker in DLBCL, which can achieve survival-risk stratification of patients. In addition, multiparametric models have the potential to effectively predict the risk of recurrence in patients.</p>\",\"PeriodicalId\":8068,\"journal\":{\"name\":\"Annals of Hematology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Hematology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00277-025-06409-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Hematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00277-025-06409-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
Feasibility analysis of metabolic parameters based on baseline 18F-FDG PET/CT to predict heterogeneity and recurrence of diffuse large B-cell lymphoma.
Objective: This study aimed to evaluate the predictive value of intra-tumoral 18F-FDG metabolic heterogeneity in patients with diffuse large B cell lymphoma (DLBCL) in terms of survival.
Methods: We retrospectively included 245 patients with DLBCL who underwent 18F-FDG PET/CT prior to treatment and analyzed using total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) as metabolic volume parameters. The linear regression slopes of TMTV and TLG were calculated according to different percentages of SUV thresholds (i.e., 40%, 50%, 60%, 70%, and 80%), respectively, defined as Heterogeneity Factor-1 (HF1) and Heterogeneity Factor-2 (HF2). These indices of heterogeneity were used to predict progression-free survival (PFS). Based on the results of the Cox proportional hazards model, we constructed a multi-parameter prediction model and evaluated the model in the training and validation cohorts by calibration curve, consistency index (C-index) and decision curve analysis (DCA).
Results: Clinicopathological and PET/CT data from 245 patients were reviewed. 153 patients (62.4%) experienced relapse after treatment. Comparing relapsed and non-relapse patients, all 18F-FDG PET/CT parameters and heterogeneity index showed significant differences. There were significant differences in survival risk stratification according to HF1 and HF2 cut-off classifications (P < 0.0001). In multivariate Cox regression analysis, SUVmax (P < 0.0001), TLG (P < 0.0001), HF1 (P = 0.004), and HF2 (P < 0.0001) showed significant results. Among the clinicopathological parameters, IPI (P = 0.027) and Size (P < 0.0001) were selected as important parameters.
Conclusions: HF1 and HF2 obtained by the linear regression slope of MTV and TLG may be a novel and useful prognostic marker in DLBCL, which can achieve survival-risk stratification of patients. In addition, multiparametric models have the potential to effectively predict the risk of recurrence in patients.
期刊介绍：
Annals of Hematology covers the whole spectrum of clinical and experimental hematology, hemostaseology, blood transfusion, and related aspects of medical oncology, including diagnosis and treatment of leukemias, lymphatic neoplasias and solid tumors, and transplantation of hematopoietic stem cells. Coverage includes general aspects of oncology, molecular biology and immunology as pertinent to problems of human blood disease. The journal is associated with the German Society for Hematology and Medical Oncology, and the Austrian Society for Hematology and Oncology.
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