Evaluation of the prognostic value of the metabolic volumetric parameters calculated with 18F-FDG PET/CT and its value added to the molecular characteristics in patients with diffuse large B-cell lymphoma

Abstract

Introduction and objectives: Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are prognostic predictors in patients with diffuse large B-cell lymphoma (DLBCL). The objective of this study is to evaluate the prognostic impact of the baseline volumetric parameters calculated with positron emission tomography/computed tomography with ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG PET/CT) and its added value to the molecular characteristics in patients with DLBCL not otherwise specified (NOS).

Methodology: This is a retrospective observational study, which included 35 patients who underwent a baseline ¹⁸F-FDG PET/CT prior to treatment. A univariate analysis of the volumetric parameters (MTV and TLG), immunohistochemical study and chromosomal translocations were performed. The method for calculating the volumetric parameters was the SUV 2.5 threshold. The comparison between the predictive models was selected based on the information criterion value of Akaike (AIC), bayesian (BIC) and Harrell's C, after performing a Cox proportional hazards regression model. In addition, a univariate analysis of the volumetric parameters was performed according to the data of the immunohistochemical study using the Wilcoxon-Mann-Whitney test.

Results: A univariate analysis revealed that VMT and TLG are predictors of progression-free survival (PFS) and overall survival (OS), with a high discrimination capacity. Adding VMT and TLG to the immunohistochemical study and chromosomal translocation provided a better prognostic value for PFS and OS in patients diagnosed with DLBCL-NOS. Likewise, it was evidenced that the values of the volumetric parameters were lower in patients who presented a germinal center B cell phenotype (GCB) compared to patients with an activated B cell phenotype (ABC) who presented higher values.

Conclusion: MTV and TLG added to the immunohistochemical study and chromosomal translocation provided a better prognostic value for PFS and OS in patients diagnosed with DLBCL-NOS.

Keywords: Diffuse large B cell lymphoma; Glicólisis total de la lesión; Linfoma B difuso de células grandes; Positron emission tomography; Tomografía por emisión de positrones; Total lesion glycolysis; Tumor metabolic volume; Volumen metabólico tumoral.