Predictive Value of PET Response Combined with Baseline Metabolic Tumor Volume in Peripheral T-Cell Lymphoma Patients.
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
Membres identifiés du Cancéropôle Est :
Dr CASASNOVAS Olivier
Tous les auteurs :
Cottereau AS, El-Galaly TC, Becker S, Broussais F, Petersen LJ, Bonnet C, Prior JO, Tilly H, Hutchings M, Casasnovas O, Meignan M
Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive non-Hodgkin lymphomas with poor outcomes on current therapy. We investigated whether response assessed with PET/CT combined with baseline total metabolic tumor volume (TMTV) could detect early relapse or refractory disease. From 7 European centers, 140 patients with nodal PTCL who underwent baseline PET/CT were selected. Forty-three had interim PET (iPET) performed after 2 cycles (iPET2), 95 had iPET performed after 3 or 4 cycles (iPET3/4), and 96 had end-of-treatment PET (eotPET). Baseline TMTV was computed with a 41% SUV threshold, and PET response was reported using the Deauville 5-point scale. With a median of 43 mo of follow-up, the 2-y progression-free survival (PFS) and overall survival (OS) were 51% and 67%, respectively. iPET2-positive patients (Deauville score ≥ 4) had a significantly worse outcome than iPET2-negative patients ( < 0.0001, hazard ratio of 6.8 for PFS; < 0.0001, hazard ratio of 6.6 for OS). The value of iPET3/4 was also confirmed for PFS ( < 0.0001) and OS ( < 0.0001). The 2-y PFS and OS for iPET3/4-positive ( = 28) and iPET3/4-negative ( = 67) patients were 16% and 32% versus 75% and 85%, respectively. The eotPET results also reflected patient outcome. A model combining TMTV and iPET3/4 stratified the population into distinct risk groups (TMTV ≤ 230 cm and iPET3/4-negative [2-y PFS/OS, 79%/85%]; TMTV > 230 cm and iPET3/4-negative [59%/84%]; TMTV ≤ 230 cm and iPET3/4-positive [42%/50%]; TMTV > 230 cm and iPET3/4-positive [0%/18%]). iPET response is predictive of outcome and allows early detection of high-risk PTCL patients. Combining iPET with TMTV improves risk stratification in individual patients.
PET/CT, PTCLs, interim PET, lymphoma, metabolic tumor volume
J. Nucl. Med.. 2018 Apr;59(4):589-595