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KMID : 0338420240390020327
The Korean Journal of Internal Medicine
2024 Volume.39 No. 2 p.327 ~ p.337
Prognostic significance of sequential 18F-FDG PET/CT during frontline treatment of peripheral T cell lymphomas
Song Ga-Young

Jung Sung-Hoon
Ahn Seo-Yeon
Kim Mi-Hee
Ahn Jae-Sook
Lee Je-Jung
Kim Hyeoung-Joon
Moon Jang-Bae
Yoo Su-Woong
Kwon Seong-Young
Min Jung-Joon
Bom Hee-Seung
Kang Sae-Ryung
Yang Deok-Hwan
Abstract
Background/Aims: The prognostic significance of 18F-fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET/CT) in peripheral T-cell lymphomas (PTCLs) are controversial. We explored the prognostic impact of sequential 18F-FDG PET/CT during frontline chemotherapy of patients with PTCLs.

Methods: In total, 143 patients with newly diagnosed PTCLs were included. Sequential 18F-FDG PET/CTs were performed at the time of diagnosis, during chemotherapy, and at the end of chemotherapy. The baseline total metabolic tumor volume (TMTV) was calculated using the the standard uptake value with a threshold method of 2.5.

Results: A baseline TMTV of 457.0 cm3 was used to categorize patients into high and low TMTV groups. Patients with a requirehigh TMTV had shorter progression-free survival (PFS) and overall survival (OS) than those with a low TMTV (PFS, 9.8 vs. 26.5 mo, p = 0.043; OS, 18.9 vs. 71.2 mo, p = 0.004). The interim 18F-FDG PET/CT response score was recorded as 1, 2?3, and 4?5 according to the Deauville criteria. The PFS and OS showed significant differences according to the interim 18F-FDG PET/CT response score (PFS, 120.7 vs. 34.1 vs. 5.1 mo, p < 0.001; OS, not reached vs. 61.1 mo vs. 12.1 mo, p < 0.001).

Conclusions: The interim PET/CT response based on visual assessment predicts disease progression and survival outcome in PTCLs. A high baseline TMTV is associated with a poor response to anthracycline-based chemotherapy in PTCLs. However, TMTV was not an independent predictor for PFS in the multivariate analysis.
KEYWORD
Peripheral T-cell lymphoma, PET-CT scan, Prognosis, Progression-free survival
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