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Abstract
PURPOSE OF REVIEW Functional imaging with 18FDG-PET-CT has transformed the staging and response assessment of patients with Hodgkin (HL) and non-Hodgkin lymphoma (NHL). Herein, we review the current role and future directions for functional imaging in the management of patients with lymphoma. RECENT FINDINGS Because of its increased sensitivity, PET-CT is the preferred modality for staging of FDG-avid lymphomas. It appears to have a role for interim assessment in patients with HL with adaptive strategies that reduce toxicity in lower risk patients and increase efficacy in those at high risk. Such a role has yet to be demonstrated in other histologies. FDG-PET-CT is also the gold standard for response assessment posttreatment. Newer uses include assessment of total metabolic tumor volume and radiomics in pretreatment prognosis. Whereas PET-CT is more sensitive than other current modalities for staging and response assessment, the future of PET-CT will be in conjunction with other modalities, notably assessment of minimal residual disease and microenvironmental markers to develop risk adaptive strategies to improve the outcome of patients with lymphoma.
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Meignan M, Cottereau AS, Specht L, Mikhaeel NG. Total tumor burden in lymphoma - an evolving strong prognostic parameter. Br J Radiol 2021; 94:20210448. [PMID: 34379496 DOI: 10.1259/bjr.20210448] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Total metabolic tumor volume (TMTV), a new parameter extracted from baseline FDG-PET/CT, has been recently proposed by several groups as a prognosticator in lymphomas before first-line treatment. TMTV, the sum of the metabolic volume of each lesion, is an index of the metabolically most active part of the tumor and highly correlates with the total tumor burden. TMTV measurement is obtained from PET images processed with different software and techniques, many being now freely available. In the various lymphoma subtypes where it has been measured, such as diffuse large B-cell lymphoma, Hodgkin lymphoma, Follicular Lymphoma, and Peripheral T-cell lymphoma, TMTV has been reported as a strong predictor of outcome (progression-free survival and overall survival) often outperforming the clinical scores, molecular predictors, and results of interim PET. Combined with these scores, TMTV improves the stratification of the populations into risk groups with different outcomes. TMTV cut-off separating the high-risk from the low-risk population impacts the outcome whatever the technique used for its measurement and an international harmonization is ongoing. TMTV is a unique and easy tool that could replace the surrogate of tumor burden included in the prognostic indexes used in lymphoma and help tailor therapy. Other parameters extracted from the baseline PET may give an information on the dissemination of this total tumor volume such as the maximum distance between the lesions. Trials based on TMTV would probably demonstrate its predictive value.
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Affiliation(s)
- Michel Meignan
- LYSA Imaging, Henri Mondor University Hospitals, University Paris Est, Créteil, France
| | | | - Lena Specht
- Dept. of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - N George Mikhaeel
- Department of Clinical Oncology, Guy's & St Thomas' NHS Trust and School of Cancer and Pharmaceutical Sciences, King's College London University, London, United Kingdom
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Prognostic Values of Baseline 18F-FDG PET/CT in Patients with Peripheral T-Cell Lymphoma. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9746716. [PMID: 32185229 PMCID: PMC7061150 DOI: 10.1155/2020/9746716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 02/07/2020] [Indexed: 12/16/2022]
Abstract
Purpose In the present study, we aimed to investigate whether the metabolic parameters on baseline 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) could be used to predict prognosis in peripheral T-cell lymphomas (PTCL). Methods A total of 51 nodal PTCL patients who underwent baseline 18F-FDG PET/CT were retrospectively evaluated in the present study. Total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were also assessed. Besides, the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) was also included. Log-rank test and Cox regression analysis were used to evaluate progression-free survival (PFS) and overall survival (OS). Results The median follow-up was 18 months. Patients with low TLG, TMTV, and SUVmax levels had a significantly better clinical outcome than those with high TLG, TMTV, and SUVmax levels. The 2-year PFS rates of the high- and low-TMTV groups were 34.62% and 80%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (p < 0.001), whereas the corresponding 2-year OS rates were 46.15% and 84.00%, respectively (n = 10), intermediate-risk group with TMTV > 62.405 or NCCN-IPI score of 4-8 (2-year PFS and OS were 52.4% and 66.7%, respectively, n = 10), intermediate-risk group with TMTV > 62.405 or NCCN-IPI score of 4-8 (2-year PFS and OS were 52.4% and 66.7%, respectively, n = 10), intermediate-risk group with TMTV > 62.405 or NCCN-IPI score of 4-8 (2-year PFS and OS were 52.4% and 66.7%, respectively, Conclusions Baseline TMTV and TLG were independent predictors of PFS and OS in PTCL patients, and SUVmax and NCCN-IPI scores were also independent predictors of OS. Moreover, the combination of TMTV and NCCN-IPI scores improved patient risk-stratification at the initial stage and might contribute to the adjustment of the therapeutic regime. This trial is registered with ChiCTR1900025526.
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Gao L, Xiang X, Zhang C, Gao L, Yang T, Wang S, Li B, Lou S, Yi Su, Liu Y, Zhang X. Upfront autologous hematopoietic stem cell transplantation in patients with high-risk stage III to IV Hodgkin lymphoma: a multicenter retrospective cohort study. ACTA ACUST UNITED AC 2019; 24:225-231. [PMID: 31081725 DOI: 10.1080/16078454.2018.1555024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND/OBJECTIVE Nearly 30% of patients with advanced-stage Hodgkin lymphoma (HL) are not cured. We should better control tumors with initial treatment for patients with advanced stage HL whose interim positron emission tomography/computed tomography (PET/CT) was positive. The objective of our study was to confirm the superiority of autologous hematopoietic stem cell transplantation (ASCT) therapy in these patients. METHODS Eighty-nine HL patients with stage III-IV, international prognostic score (IPS) ≥3 and Deauville more than 3° at the interim PET/CT were analyzed. Forty five patients received ASCT. The other 44 patients received two cycles DHAP chemotherapy. RESULTS The 3-year overall survival (OS) of patients who received ASCT was 91.1%, and for the patients who received chemotherapy, it was 72.7% (P = 0.025). The 3-year progression free survival (PFS) of patients in the ASCT group was 88.9%, but for patients in the chemotherapy group, it was only 70.5%(P = 0.017). No patient died of toxicity from ASCT. Additionally, there was no difference in the rates of secondary malignancies between the ASCT and chemotherapy groups. Extranodal and bone marrow involvement were poor prognostic factors, while ASCT was a good prognostic factor. CONCLUSION The use of ASCT as a first-line consolidation treatment could improve outcome of patients with advanced-stage high risk HL whose interim PET/CT was positive.
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Affiliation(s)
- Li Gao
- a Department of Hematology, Xinqiao Hospital , Army Military Medical University , Chongqing , People's Republic of China
| | - Xixi Xiang
- a Department of Hematology, Xinqiao Hospital , Army Military Medical University , Chongqing , People's Republic of China
| | - Cheng Zhang
- a Department of Hematology, Xinqiao Hospital , Army Military Medical University , Chongqing , People's Republic of China
| | - Lei Gao
- a Department of Hematology, Xinqiao Hospital , Army Military Medical University , Chongqing , People's Republic of China
| | - Tonghua Yang
- b Department of Hematology , Yunnan Provincial People's Hospital , Yunnan , People's Republic of China
| | - Sanbin Wang
- c Department of Hematology , General Hospital of Kunming Military Region of PLA , Yunnan , People's Republic of China
| | - Bin Li
- d Department of Hematology , Yunnan Provincial Second People's Hospital , Yunnan , People's Republic of China
| | - Shifeng Lou
- e Department of Hematology, The Second Affiliated Hospital , Chongqing Medical University , Chongqing , People's Republic of China
| | - Yi Su
- f Department of Hematology , General Hospital of Chengdu Military Region of PLA , Sichuan , People's Republic of China
| | - Yao Liu
- a Department of Hematology, Xinqiao Hospital , Army Military Medical University , Chongqing , People's Republic of China
| | - Xi Zhang
- a Department of Hematology, Xinqiao Hospital , Army Military Medical University , Chongqing , People's Republic of China
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Meignan M. High-risk interim PET negative patients in Hodgkin's lymphoma. LANCET HAEMATOLOGY 2017; 3:e449-e450. [PMID: 27692302 DOI: 10.1016/s2352-3026(16)30126-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 08/15/2016] [Indexed: 12/31/2022]
Affiliation(s)
- Michel Meignan
- LYSA Imaging, Department of Nuclear Medicine, Hôpital Henri Mondor, University Paris Est Créteil, Créteil, 94010, France.
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Cottereau AS, Mulé S, Lin C, Belhadj K, Vignaud A, Copie-Bergman C, Boyez A, Zerbib P, Tacher V, Scherman E, Haioun C, Luciani A, Itti E, Rahmouni A. Whole-Body Diffusion-weighted MR Imaging of Iron Deposits in Hodgkin, Follicular, and Diffuse Large B-Cell Lymphoma. Radiology 2017; 286:560-567. [PMID: 28985135 DOI: 10.1148/radiol.2017170599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose To analyze the frequency and distribution of low-signal-intensity regions (LSIRs) in lymphoma lesions and to compare these to fluorodeoxyglucose (FDG) uptake and biologic markers of inflammation. Materials and Methods The authors analyzed 61 untreated patients with a bulky lymphoma (at least one tumor mass ≥7 cm in diameter). When a LSIR within tumor lesions was detected on diffusion-weighted images obtained with a b value of 50 sec/mm2, a T2-weighted gradient-echo (GRE) sequence was performed and calcifications were searched for with computed tomography (CT). In two patients, Perls staining was performed on tissue samples from the LSIR. LSIRs were compared with biologic inflammatory parameters and baseline FDG positon emission tomography (PET)/CT parameters (maximum standardized uptake value [SUVmax], total metabolic tumor volume [TMTV]). Results LSIRs were detected in 22 patients and corresponded to signal void on GRE images; one LSIR was due to calcifications, and three LSIRS were due to a recent biopsy. In 18 patients, LSIRs appeared to be related to focal iron deposits; this was proven with Perls staining in two patients. The LSIRs presumed to be due to iron deposits were found mostly in patients with aggressive lymphoma (nine of 26 patients with Hodgkin lymphoma and eight of 20 patients with diffuse large B-cell lymphoma vs one of 15 patients with follicular lymphoma; P = .047) and with advanced stage disease (15 of 18 patients). LSIRS were observed in spleen (n = 14), liver (n = 3), and nodal (n = 8) lesions and corresponded to foci FDG uptake, with mean SUVmax of 9.8, 6.7, and 16.2, respectively. These patients had significantly higher serum levels of C-reactive protein, α1-globulin, and α2-globulin and more frequently had microcytic anemia than those without such deposits (P = .0072, P = .003, P = .0068, and P < .0001, respectively). They also had a significantly higher TMTV (P = .0055) and higher levels of spleen involvement (P < .0001). Conclusion LSIRs due to focal iron deposits are detected in lymphoma lesions and are associated with a more pronounced biologic inflammatory syndrome. © RSNA, 2017 Online supplemental material is available for this article.
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Affiliation(s)
- Anne-Ségolène Cottereau
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Sébastien Mulé
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Chieh Lin
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Karim Belhadj
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Alexandre Vignaud
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Christiane Copie-Bergman
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Alice Boyez
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Pierre Zerbib
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Vania Tacher
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Elodie Scherman
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Corinne Haioun
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Alain Luciani
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Emmanuel Itti
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
| | - Alain Rahmouni
- From the Department of Nuclear Medicine (A.S.C., E.I.), Department of Medical Imaging (A.S.C., S.M., P.Z., V.T., A.L., A.R.), Lymphoid Malignancies Unit (K.B., E.S., C.H.), and Department of Pathology (C.C.B., A.B.), AP-HP, Groupe Henri Mondor Albert Chenevier, CHU Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, Université Paris Est Créteil, 94010 Creteil, France; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan (C.L.); NeuroSpin, Gif-sur-Yvette, France (A.V.); INSERM IMRB U955 Equipe 18, Paris, France (V.T., A.L.); and UPEC, Paris, France (V.T., A.L., A.R.)
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Meignan M, Cottereau AS, Versari A, Chartier L, Dupuis J, Boussetta S, Grassi I, Casasnovas RO, Haioun C, Tilly H, Tarantino V, Dubreuil J, Federico M, Salles G, Luminari S, Trotman J. Baseline Metabolic Tumor Volume Predicts Outcome in High-Tumor-Burden Follicular Lymphoma: A Pooled Analysis of Three Multicenter Studies. J Clin Oncol 2016; 34:3618-3626. [PMID: 27551111 DOI: 10.1200/jco.2016.66.9440] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Identifying patients at high risk of progression and early death among those with high-tumor-burden follicular lymphoma (FL) is unsatisfactory with current prognostic models. This study aimed to determine the prognostic impact of the total metabolic tumor volume (TMTV) measured at baseline with [18F]fluorodeoxyglucose/positron emission tomography-computed tomography ([18F]FDG/PET-CT) scans and its added value to these models. PATIENTS AND METHODS A pooled analysis was performed by using patient data and centrally reviewed baseline PET-CT scans for 185 patients with FL who were receiving immunochemotherapy within three prospective trials. TMTV was computed by using the 41% maximum standardized uptake value thresholding method, and the optimal cutoff for survival prediction was determined. RESULTS Median age was 55 years, 92% of patients had stage III to IV disease, 37% had a Follicular Lymphoma International Prognostic Index (FLIPI) score of 3 to 5, and 31% had a FLIPI2 score of 3 to 5. With a median follow-up of 64 months, overall 5-year progression-free survival (PFS) was 55% and overall survival (OS) was 92%. Median TMTV was 297 cm3 (quartile 1 through quartile 3, 135 to 567 cm3). The optimal cutoff identified was 510 cm3, with a markedly inferior survival in the 29% of patients with TMTV > 510 cm3. Five-year PFS was 33% versus 65% (hazard ratio [HR], 2.90; P < .001), and 5-year OS was 85% versus 95% (HR, 3.45; P = .010). On multivariable analysis, TMTV (HR, 2.3; P = .002) and FLIPI2 score (HR, 2.2; P = .002) were independent predictors of PFS. In combination, they identify three risk groups: high TMTV and intermediate-to-high FLIPI2 score with 5-year PFS of 20% (HR, 5.0; P < .001), high TMTV or intermediate-to-high FLIPI2 score with 5-year PFS of 46% (HR, 2.1; P = .007), and low TMTV and low FLIP2 with 5-year PFS of 69%. CONCLUSION Baseline TMTV is a strong independent predictor of outcome in FL. In combination with FLIPI2 score, it identifies patients at high risk of early progression. It warrants further validation as a biomarker for development of first-line PET-adapted approaches in FL.
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Affiliation(s)
- Michel Meignan
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Anne Ségolène Cottereau
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Annibale Versari
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Loïc Chartier
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Jehan Dupuis
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Sami Boussetta
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Ilaria Grassi
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - René-Olivier Casasnovas
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Corinne Haioun
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Hervé Tilly
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Vittoria Tarantino
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Julien Dubreuil
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Massimo Federico
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Gilles Salles
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Stefano Luminari
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
| | - Judith Trotman
- Michel Meignan, Anne Ségolène Cottereau, Jehan Dupuis, and Corinne Haioun, Université Paris-Est Créteil, Créteil; Loïc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Université Claude Bernard Lyon 1, Pierre Bénite; René-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Hervé Tilly, Université de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano Luminari, Arcispedale S. Maria Nuova IRCCS, University of Modena and Reggio Emilia, Reggio Emilia; Vittoria Tarantino and Massimo Federico, University of Modena and Reggio Emilia, Modena, Italy; and Judith Trotman, University of Sydney, Concord, New South Wales, Australia
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Kanoun S, Tal I, Berriolo-Riedinger A, Rossi C, Riedinger JM, Vrigneaud JM, Legrand L, Humbert O, Casasnovas O, Brunotte F, Cochet A. Influence of Software Tool and Methodological Aspects of Total Metabolic Tumor Volume Calculation on Baseline [18F]FDG PET to Predict Survival in Hodgkin Lymphoma. PLoS One 2015; 10:e0140830. [PMID: 26473950 PMCID: PMC4608733 DOI: 10.1371/journal.pone.0140830] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/29/2015] [Indexed: 11/19/2022] Open
Abstract
AIM To investigate the respective influence of software tool and total metabolic tumor volume (TMTV0) calculation method on prognostic stratification of baseline 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]FDG-PET) in newly diagnosed Hodgkin lymphoma (HL). METHODS 59 patients with newly diagnosed HL were retrospectively included. [18F]FDG-PET was performed before any treatment. Four sets of TMTV0 were calculated with Beth Israel (BI) software: based on an absolute threshold selecting voxel with standardized uptake value (SUV) >2.5 (TMTV02.5), applying a per-lesion threshold of 41% of the SUV max (TMTV041) and using a per-patient adapted threshold based on SUV max of the liver (>125% and >140% of SUV max of the liver background; TMTV0125 and TMTV0140). TMTV041 was also determined with commercial software for comparison of software tools. ROC curves were used to determine the optimal threshold for each TMTV0 to predict treatment failure. RESULTS Median follow-up was 39 months. There was an excellent correlation between TMTV041 determined with BI and with the commercial software (r = 0.96, p<0.0001). The median TMTV0 value for TMTV041, TMTV02.5, TMTV0125 and TMTV0140 were respectively 160 (used as reference), 210 ([28;154] p = 0.005), 183 ([-4;114] p = 0.06) and 143 ml ([-58;64] p = 0.9). The respective optimal TMTV0 threshold and area under curve (AUC) for prediction of progression free survival (PFS) were respectively: 313 ml and 0.70, 432 ml and 0.68, 450 ml and 0.68, 330 ml and 0.68. There was no significant difference between ROC curves. High TMTV0 value was predictive of poor PFS in all methodologies: 4-years PFS was 83% vs 42% (p = 0.006) for TMTV02.5, 83% vs 41% (p = 0.003) for TMTV041, 85% vs 40% (p<0.001) for TMTV0125 and 83% vs 42% (p = 0.004) for TMTV0140. CONCLUSION In newly diagnosed HL, baseline metabolic tumor volume values were significantly influenced by the choice of the method used for determination of volume. However, no significant differences were found in term of prognosis.
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Affiliation(s)
- Salim Kanoun
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
- Le2i UMR CNRS 6306, Dijon, France
- MRI Unit, Centre Hospitalier Régional Universitaire, Hôpital Le Bocage, Dijon, France
- * E-mail:
| | - Ilan Tal
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | | | - Cédric Rossi
- Department of Clinical Hematology, Centre Hospitalier Régional Universitaire, Hôpital Le Bocage, Dijon, France
| | - Jean-Marc Riedinger
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
| | - Jean-Marc Vrigneaud
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
| | | | - Olivier Humbert
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
- Le2i UMR CNRS 6306, Dijon, France
| | - Olivier Casasnovas
- Department of Clinical Hematology, Centre Hospitalier Régional Universitaire, Hôpital Le Bocage, Dijon, France
- Inserm U866, Labex team, Faculté de Médecine, Université de Bourgogne, Dijon, France
| | - François Brunotte
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
- Le2i UMR CNRS 6306, Dijon, France
- MRI Unit, Centre Hospitalier Régional Universitaire, Hôpital Le Bocage, Dijon, France
| | - Alexandre Cochet
- Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France
- Le2i UMR CNRS 6306, Dijon, France
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9
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Meignan M, Hutchings M, Schwartz LH. Imaging in Lymphoma: The Key Role of Fluorodeoxyglucose-Positron Emission Tomography. Oncologist 2015; 20:890-5. [PMID: 26173837 DOI: 10.1634/theoncologist.2015-0036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 03/20/2015] [Indexed: 01/14/2023] Open
Affiliation(s)
- Michel Meignan
- Centre Universitaire Hospitalier Henri Mondor, Lymphoma Study Association Imaging, Créteil, France; Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Columbia University Medical Center, New York, New York, USA
| | - Martin Hutchings
- Centre Universitaire Hospitalier Henri Mondor, Lymphoma Study Association Imaging, Créteil, France; Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Columbia University Medical Center, New York, New York, USA
| | - Lawrence H Schwartz
- Centre Universitaire Hospitalier Henri Mondor, Lymphoma Study Association Imaging, Créteil, France; Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Columbia University Medical Center, New York, New York, USA
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10
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Carlier T, Bailly C. State-Of-The-Art and Recent Advances in Quantification for Therapeutic Follow-Up in Oncology Using PET. Front Med (Lausanne) 2015; 2:18. [PMID: 26090365 PMCID: PMC4370108 DOI: 10.3389/fmed.2015.00018] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 03/09/2015] [Indexed: 12/28/2022] Open
Abstract
18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET) is an important tool in oncology. Its use has greatly progressed from initial diagnosis to staging and patient monitoring. The information derived from 18F-FDG-PET allowed the development of a wide range of PET quantitative analysis techniques ranging from simple semi-quantitative methods like the standardized uptake value (SUV) to “high order metrics” that require a segmentation step and additional image processing. In this review, these methods are discussed, focusing particularly on the available methodologies that can be used in clinical trials as well as their current applications in international consensus for PET interpretation in lymphoma and solid tumors.
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Affiliation(s)
- Thomas Carlier
- Nuclear Medicine Department, University Hospital , Nantes , France ; CRCNA, INSERM U892, CNRS UMR 6299 , Nantes , France
| | - Clément Bailly
- Nuclear Medicine Department, University Hospital , Nantes , France
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11
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Meignan M, Itti E, Gallamini A, Younes A. FDG PET/CT imaging as a biomarker in lymphoma. Eur J Nucl Med Mol Imaging 2015; 42:623-33. [PMID: 25573631 DOI: 10.1007/s00259-014-2973-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 12/08/2014] [Indexed: 12/12/2022]
Abstract
FDG PET/CT has changed the management of FDG-avid lymphoma and is now recommended as the imaging technique of choice for staging and restaging. The need for tailoring therapy to reduce toxicity in patients with a favourable outcome and for improving treatment in those with high-risk factors requires accurate diagnostic methods and a new prognostic algorithm to identify different risk categories. New drugs are used in relapsed/refractory patients. The role of FDG PET/CT as a biomarker in this context is summarized in this review. New trends in FDG metabolic imaging in lymphoma are addressed including metabolic tumour volume measurement at staging and integrative PET which combines PET data with clinical and molecular markers or other imaging techniques. The quantitative approach for response assessment which is under investigation and is used in large ongoing trials is compared with visual criteria. The place of FDG in the era of targeted therapy is discussed.
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Affiliation(s)
- Michel Meignan
- LYSA Imaging, Department of Nuclear Medicine, Hôpitaux Universitaires Henri Mondor, Paris-Est Créteil University, Créteil, 94010, France,
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