Role of 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography Imaging in the Prediction of Prognosis in Patients With Indolent Lymphoma: Prospective Study

Nawal Faiez AlShehry; Raja Shanker; Syed Ziauddin Ahmed Zaidi; Fahad AlGhmlas; Ibraheem Hussein Motabi; Shahid Iqbal; Ahmad Ali Butt; Hassan AlShehri; Imran Khan Tailor; Syed Yasir Altaf; Mubarak AlGhamdi; Mohammed Marie; Mansour AlFayez; Kamal Al Zahrani; Mohammed Dwaimah; Tahani Al-Halouli; Wafaa Al-Shakweer; Maied Zaher AlShehery; Abdul Rehman Zia Zaidi; Atta Munawar Gill; Belal Mohammed Albtoosh; Musab Ahmed

doi:10.2196/24936

Role of 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography Imaging in the Prediction of Prognosis in Patients With Indolent Lymphoma: Prospective Study

JMIR Form Res. 2021 Nov 12;5(11):e24936. doi: 10.2196/24936.

Authors

Nawal Faiez AlShehry¹, Raja Shanker^#², Syed Ziauddin Ahmed Zaidi^#¹, Fahad AlGhmlas², Ibraheem Hussein Motabi¹, Shahid Iqbal¹, Ahmad Ali Butt¹, Hassan AlShehri¹, Imran Khan Tailor¹, Syed Yasir Altaf¹, Mubarak AlGhamdi¹, Mohammed Marie¹, Mansour AlFayez¹, Kamal Al Zahrani¹, Mohammed Dwaimah¹, Tahani Al-Halouli³, Wafaa Al-Shakweer³, Maied Zaher AlShehery⁴, Abdul Rehman Zia Zaidi¹, Atta Munawar Gill¹, Belal Mohammed Albtoosh¹, Musab Ahmed²

Affiliations

¹ Department of Adult Hematology/Bone Marrow Transplantation, King Fahad Medical City, Riyadh, Saudi Arabia.
² Department of Radiology and Nuclear Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
³ Department of Pathology and Laboratory Medicine, King Fahad Medical City, Riyadh, Saudi Arabia.
⁴ Department of Palliative Care, King Fahad Medical City, Riyadh, Saudi Arabia.

^# Contributed equally.

PMID: 34508363
PMCID: PMC8663482
DOI: 10.2196/24936

Abstract

Background: The role of fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in indolent lymphoma has been minimally studied.

Objective: This study aims to assess the value of FDG-PET/CT in predicting the prognosis of indolent lymphoma.

Methods: We prospectively recruited 42 patients with indolent lymphoma. A total of 2 patients were excluded, and 40 underwent baseline PET/CT and follow-up at various time points. A total of 9 patients were observed only, 7 received 4 doses of rituximab alone, and 24 received chemoimmunotherapy. Metabolic response on follow-up PET/CT was assessed using the maximum standardized uptake value (SUVmax) and Deauville criteria (DC). We aimed to obtain the best SUVmax and DC to predict optimal survival rates, risk stratification, and optimize therapeutic strategies. The mean follow-up from the initial diagnosis was 33.83 months.

Results: SUVmax <4.35 at interim PET/CT provided the best discrimination, with a progression-free survival (PFS) of 100% and a median survival time of 106.67 months compared with SUVmax ≥4.35 (P=.04), which had a PFS of 43.8% and a median survival time of 50.17 months. This cutoff was also valuable in predicting overall survival at baseline, that is, 100% overall survival with baseline SUVmax <4.35, versus 58.4% for SUVmax ≥4.35 (P=.13). The overall survival of patients with a baseline DC score <3.0 was 100%, with a median overall survival of 106.67 months.

Conclusions: We demonstrated the utility of PET/CT in indolent lymphomas. SUVmax (<4.35 vs ≥4.35) on interim PET/CT performed best in predicting PFS.

Keywords: Deauville criteria; SUVmax; indolent lymphoma; lymphoma; positron emission tomography; prognosis.

©Nawal Faiez AlShehry, Raja Shanker, Syed Ziauddin Ahmed Zaidi, Fahad AlGhmlas, Ibraheem Hussein Motabi, Shahid Iqbal, Ahmad Ali Butt, Hassan AlShehri, Imran Khan Tailor, Syed Yasir Altaf, Mubarak AlGhamdi, Mohammed Marie, Mansour AlFayez, Kamal Al Zahrani, Mohammed Dwaimah, Tahani Al-Halouli, Wafaa Al-Shakweer, Maied Zaher AlShehery, Abdul Rehman Zia Zaidi, Atta Munawar Gill, Belal Mohammed Albtoosh, Musab Ahmed. Originally published in JMIR Formative Research (https://formative.jmir.org), 12.11.2021.