“Staging, restaging and treatment response assessment” in lymphomas: what we should know.

International audienc

Baseline Total Metabolic Tumor Volume Measured with Fixed or Different Adaptive Thresholding Methods Equally Predicts Outcome in Peripheral T Cell Lymphoma

International audienceThe purpose of this study was to compare in a large series of peripheral T cell lymphoma, as a model of diffuse disease, the prognostic value of baseline total metabolic tumor volume (TMTV) measured on 18F-FDG PET/CT with adaptive thresholding methods with TMTV measured with a fixed 41% SUVmax threshold method

Report on the 4th International Workshop on Positron Emission Tomography in Lymphoma held in Menton, France, 3–5 October 2012

One hundred and seventy-five hemato-oncologists and nuclear medicine specialists from 23 countries joined the 2-day 4th International Workshop on Positron Emission Tomography in Lymphoma held in October 2012. The meeting was under the auspices of the European Lymphoma Institute, the Lymphoma Study Association (LYSA) and Fondazione Italiana Linfomi (FIL). Thirty-nine scientific posters were presented or discussed in the plenary session. A group of nuclear medicine and radiology experts presented and discussed with the audience their final report on lymphoma staging and restaging with positron emission tomography (PET). The same report will be presented in a dedicated workshop during the 12th International Conference on Malignant Lymphoma (ICML) in Lugano. Mainly, it was proposed to use the same type of criteria (Deauville five-point scale) for interim and end of treatment PET reporting. Results were presented on the state of the art of the role of PET in staging and response assessment in follicular lymphoma, mucosa-associated lymphoid tissue (MALT) lymphoma, primary mediastinal large B-cell lymphoma (PMBCL), mantle cell lymphoma and T cell lymphoma. Although PET is now recognized as a useful tool in follicular lymphoma, prospective data should be acquired on a larger scale to better define its role in the other subtypes. Technical and clinical focus was given to the measurement of metabolic volume to evaluate the total tumor burden, and interim PET-based ongoing trials were presented for LYSA and FIL. Final results of international validation studies of Deauville criteria and change in maximum standardized uptake value (ΔSUVmax) analysis were presented for Hodgkin lymphoma and diffuse large B-cell lymphoma. A closed meeting was held addressing the issue of contrast-enhanced computed tomography (CT) in the PET/CT era. The next meeting (September 2014) will be open to all imaging modalities used for lymphoma investigation

Pretherapy metabolic tumour volume is an independent predictor of outcome in patients with diffuse large B-cell lymphoma.

International audienceWe investigated the prognostic value of total metabolic tumour volume (TMTV) in diffuse large B-cell lymphoma (DLBCL). TMTV was measured in 114 patients with newly diagnosed DLBCL who underwent (18)F-FDG PET/CT at baseline before immunochemotherapy. TMTV was computed by summing the volumes of all lymphomatous lesions after applying the local SUVmax threshold of 41% using semiautomatic software. Prognostic value was assessed by Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS). Median follow-up was 39 months. Average pretherapy TMTV was 509 ± 568 cm(3). The 3-year estimates of PFS were 77 % in the low metabolic burden group (TMTV ≤550 cm(3)) and 60% in the high metabolic burden group (TMTV >550 cm(3), p = 0.04), and prediction of OS was even better (87% vs. 60%, p = 0.0003). Cox regression showed independence of TMTV for OS prediction (p = 0.002) compared with other pretherapy indices of tumour burden, such as tumour bulk and the International Prognostic Index. Pretherapy TMTV is an independent predictor of outcome in patients with DLBCL

Pretherapy metabolic tumour volume is an independent predictor of outcome in patients with diffuse large B-cell lymphoma.

International audienceWe investigated the prognostic value of total metabolic tumour volume (TMTV) in diffuse large B-cell lymphoma (DLBCL). TMTV was measured in 114 patients with newly diagnosed DLBCL who underwent (18)F-FDG PET/CT at baseline before immunochemotherapy. TMTV was computed by summing the volumes of all lymphomatous lesions after applying the local SUVmax threshold of 41% using semiautomatic software. Prognostic value was assessed by Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS). Median follow-up was 39 months. Average pretherapy TMTV was 509 ± 568 cm(3). The 3-year estimates of PFS were 77 % in the low metabolic burden group (TMTV ≤550 cm(3)) and 60% in the high metabolic burden group (TMTV >550 cm(3), p = 0.04), and prediction of OS was even better (87% vs. 60%, p = 0.0003). Cox regression showed independence of TMTV for OS prediction (p = 0.002) compared with other pretherapy indices of tumour burden, such as tumour bulk and the International Prognostic Index. Pretherapy TMTV is an independent predictor of outcome in patients with DLBCL