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Cottereau AS, Meignan M, Nioche C, Clerc J, Chartier L, Vercellino L, Casasnovas O, Thieblemont C, Buvat I. New Approaches in Characterization of Lesions Dissemination in DLBCL Patients on Baseline PET/CT. Cancers (Basel) 2021; 13:3998. [PMID: 34439152 PMCID: PMC8392801 DOI: 10.3390/cancers13163998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/01/2021] [Accepted: 08/05/2021] [Indexed: 02/07/2023] Open
Abstract
Dissemination, expressed recently by the largest Euclidian distance between lymphoma sites (SDmax), appeared a promising risk factor in DLBCL patients. We investigated alternative distance metrics to characterize the robustness of the dissemination information. In 290 patients from the REMARC trial (NCT01122472), the Euclidean (Euc), Manhattan (Man), and Tchebychev (Tch) distances between the furthest lesions, firstly based on the centroid of each lesion and then directly from the two most distant tumor voxels and the Travelling Salesman Problem distance (TSP) were calculated. For PFS, the areas under the ROC curves were between 0.63 and 0.64, and between 0.62 and 0.65 for OS. Patients with high SDmax whatever the method of calculation or high SD_TSP had a significantly poorer outcome than patients with low SDmax or SD_TSP (p < 0.001 for both PFS and OS), with significance maintained in Ann Arbor advanced-stage patients. In multivariate analysis with total metabolic tumor volume and ECOG, each distance feature had an independent prognostic value for PFS. For OS, only SDmax_Tch, SDmax_Euc _Vox, and SDmax_Man _Vox reached significance. The spread of DLBCL lesions measured by the largest distance between lymphoma sites is a strong independent prognostic factor and could be measured directly from tumor voxels, allowing its development in the area of the deep learning segmentation methods.
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Affiliation(s)
- Anne-Ségolène Cottereau
- Department of Nuclear Medicine, Cochin Hospital, AP-HP, University of Paris, 75014 Paris, France;
- LITO Laboratory, U1288, Institut Curie, Université PSL, Inserm, Université Paris Saclay, 91400 Orsay, France; (C.N.); (I.B.)
| | - Michel Meignan
- LYSA Imaging, Henri Mondor University Hospital, AP-HP, University Paris East, 94000 Créteil, France;
| | - Christophe Nioche
- LITO Laboratory, U1288, Institut Curie, Université PSL, Inserm, Université Paris Saclay, 91400 Orsay, France; (C.N.); (I.B.)
| | - Jérôme Clerc
- Department of Nuclear Medicine, Cochin Hospital, AP-HP, University of Paris, 75014 Paris, France;
| | - Loic Chartier
- The Lymphoma Academic Research Organisation, Statistic, Centre Hospitalier Lyon Sud, 69000 Pierre-Benite, France;
| | - Laetitia Vercellino
- Department of Nuclear Medicine, Saint-Louis Hospital, AP-HP, 75010 Paris, France;
| | - Olivier Casasnovas
- Department of Hematology, University Hospital of Dijon, 21231 Dijon, France;
| | - Catherine Thieblemont
- Department of Hematology, Saint-Louis Hospital, AP-HP, Hemato-Oncology, DMU DHI, 1 Av. Claude Vellefaux, 75010 Paris, France;
- Research Unit NF-kappaB, Différenciation et Cancer, Université de Paris, 12 Rue de l’École de Médecine, 75006 Paris, France
| | - Irène Buvat
- LITO Laboratory, U1288, Institut Curie, Université PSL, Inserm, Université Paris Saclay, 91400 Orsay, France; (C.N.); (I.B.)
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