Prognostic value of whole-body dynamic 18F-FDG PET/CT Patlak in diffuse large B-cell lymphoma

Jiankang Yin; Hui Wang; Gan Zhu; Ni Chen; Muhammad Imran Khan; Ye Zhao

doi:10.1016/j.heliyon.2023.e19749

Prognostic value of whole-body dynamic ¹⁸F-FDG PET/CT Patlak in diffuse large B-cell lymphoma

Heliyon. 2023 Sep 1;9(9):e19749. doi: 10.1016/j.heliyon.2023.e19749. eCollection 2023 Sep.

Authors

Jiankang Yin¹, Hui Wang², Gan Zhu², Ni Chen¹, Muhammad Imran Khan^{3

4

5}, Ye Zhao¹

Affiliations

¹ School of Basic Medical Sciences, Anhui Medical University, Hefei, PR China.
² Department of Nuclear Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, Anhui, PR China.
³ School of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230026, Anhui, PR China.
⁴ Department of Pathology, District Headquarters Hospital, Jhang, 35200, Punjab Province, Pakistan.
⁵ Hefei National Lab for Physical Sciences at Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, 230026, Anhui, PR China.

Abstract

Objective: This study aims to investigate the significance of interim whole-body dynamic ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) Patlak parameters for predicting the prognosis of patients with diffuse large B-cell lymphoma. To estimate the predictive value of the whole-body dynamic ¹⁸F-FDG PET/CT Patlak parameter for 2-year progression-free survival (PFS) and 2-year overall survival (OS).

Methods: This study reports the findings of 67 patients with diffuse large B-cell lymphoma (DLBCL). These patients underwent interim whole-body dynamic ¹⁸F-FDG PET/CT scans from June 2021 to January 2023 at the Department of Nuclear Medicine, First Affiliated Hospital of Anhui Medical University. The predictive values of maximum standard uptake value (SUV_max), maximum of net glucose uptake rate (Ki_max) and the predictive model combining Ki_max and interim treatment response on the prognosis of patients was analyzed using receiver operating characteristic (ROC) curves. Kaplan-Meier survival curves and log-rank tests were used for survival analysis. Univariate and multivariate analyses were performed to screen for independent prognostic risk factors.

Results: After a median follow-up of 18 months, 21 patients (31.3%) experienced disease recurrence or death. The cut-off values for the SUV_max and the Ki_max were 6.1 and 0.13 μmol min^-1·ml^-1, respectively. Ann Arbor stage, IPI, SUV_max, Ki_max and interim treatment response were associated with PFS and OS in the univariate analysis. However, only Ki_max and interim treatment response were independent influences on PFS and OS in multivariate analysis.

Conclusion: Interim whole-body dynamic ¹⁸F-FDG PET/CT Patlak imaging has significant prognostic value in patients with DLBCL. Among them, the interim dynamic parameter Ki_max showed the best predictive value for prognosis compared with the interim SUV_max and interim treatment response. The predictive model established by Ki_max and the interim treatment response allowed for the accurate stratification of the prognostic risk of DLBCL.

Keywords: 18F- fluorodeoxyglucose; Diffuse large B-Cell lymphoma; Patlak; Whole-body dynamic PET/CT.