Malmon Solène, Elsensohn Mad-Helenie, Thieblemont Catherine, Morschhauser Franck, Casasnovas Olivier, André Marc, Gouill Steven Le, Tabaa Yassine Al, Durand Paul Bland, Bailly Clement, Edeline Veronique, Vija Lavinia, Vercellino Laetitia, Ricci Romain, Kanoun Salim, Cottereau Anne-Ségolène
Pixilib SAS, Toulouse, France.
Biostatistics Department, LYSARC, Lyon-Sud Hospital, Pierre-Bénite, France.
Eur J Nucl Med Mol Imaging. 2025 Mar 20. doi: 10.1007/s00259-025-07176-4.
PURPOSE: This study compared the prognostic value of total metabolic tumor volume (TMTV) in lymphoma measured with the recently proposed SUV4.0 segmentation threshold versus the 41% SUVmax across LYSA trials and its impact on intensity and dissemination PET features. METHODS: A total of 1960 baseline PET/CT scans of Diffuse Large B cell lymphoma (DLBCL), follicular lymphoma (FL) and Hodgkin lymphoma (HL) patients were collected. After a semi-automatic preselection of region of interest, two different segmentation threshold were applied: 41% SUVmax (TMTV) and SUV > 4.0 (TMTV). RESULTS: The correlation between TMTV and TMTV was ρ = 0.90 for DLBCL, ρ = 0.65 for FL and ρ = 0.60 for HL. For SUVmax, SUVpeak, Dmax and Dbulk features, a strong correlation was observed with ρ > 0.95 whatever the lymphoma subtypes. The predictability of TMTV was high and comparable for the two methods with superimposable confidence intervals for the three subtypes. At the 90th percentile TMTV value, the predicted 7-year PFS was 51.13% with TMTV vs. 49.7% with TMTV for DLBCL patients, 45.5% vs. 39.8% for FL patients, and 82.6% vs. 80.5% for HL patients. A minority of patients showed a predicted PFS deviation > 10% between the two methods: 2.33% in DLBCL, 6.51% in FL and 1% in HL. CONCLUSION: TMTV measured with the SUV4.0 threshold provides a comparable PFS prediction than the 41%SUVmax method supporting its routine adoption particularly in the diffuse large B cell lymphoma subtype.
目的:本研究比较了在LYSA试验中,使用最近提出的SUV4.0分割阈值与41%SUVmax测量淋巴瘤的总代谢肿瘤体积(TMTV)的预后价值,及其对PET特征强度和扩散的影响。 方法:共收集了1960例弥漫性大B细胞淋巴瘤(DLBCL)、滤泡性淋巴瘤(FL)和霍奇金淋巴瘤(HL)患者的基线PET/CT扫描图像。在对感兴趣区域进行半自动预选后,应用了两种不同的分割阈值:41%SUVmax(TMTV)和SUV > 4.0(TMTV)。 结果:DLBCL中TMTV与TMTV的相关性为ρ = 0.90,FL中为ρ = 0.65,HL中为ρ = 0.60。对于SUVmax、SUVpeak、Dmax和Dbulk特征,无论淋巴瘤亚型如何,均观察到强相关性,ρ > 0.95。两种方法对TMTV的预测性都很高,三种亚型的置信区间重叠。在第90百分位数TMTV值时,DLBCL患者使用TMTV预测的7年无进展生存率为51.13%,使用TMTV为49.7%;FL患者为45.5%对39.8%;HL患者为82.6%对80.5%。少数患者在两种方法之间的预测无进展生存率偏差>10%:DLBCL中为2.33%,FL中为6.51%,HL中为1%。 结论:用SUV4.0阈值测量的TMTV与41%SUVmax方法提供了相当的无进展生存率预测,支持其常规应用,特别是在弥漫性大B细胞淋巴瘤亚型中。
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