Early interim PET/CT predicts post-treatment response in diffuse large B-cell lymphoma
Abstract Background. 18F-FDG-PET/CT has been widely used in the staging of malignant lymphomas, and accepted as a tool for response assessment. Among PET parameters, the most frequently studied is maximal standardized uptake value (SUVmax). Metabolic tumor burden (MTB) is a parameter in which both m...
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| Veröffentlicht in: | Acta oncologica 2014-08, Vol.53 (8), p.1093-1099 |
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| creator | Wu, Xingchen Pertovaara, Hannu Korkola, Pasi Vornanen, Martine Järvenpää, Ritva Dastidar, Prasun Eskola, Hannu Kellokumpu-Lehtinen, Pirkko-Liisa |
| description | Abstract
Background. 18F-FDG-PET/CT has been widely used in the staging of malignant lymphomas, and accepted as a tool for response assessment. Among PET parameters, the most frequently studied is maximal standardized uptake value (SUVmax). Metabolic tumor burden (MTB) is a parameter in which both metabolic tumor volume (MTV) and tumor activity are integrated. Here, we analyzed the prognostic value of SUVmax, SUVsum (sum of the SUVmax), whole-body MTV (MTVwb) and MTBwb from baseline and interim PET/CT in patients with diffuse large B-cell lymphoma (DLBCL).
Material and methods. Twenty-nine patients with histologically proven DLBCL were imaged by PET/CT before treatment (Exam I), and one week after the first dose of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy (Exam II). Biopsy specimens were examined by an expert hematopathologist, the Ki-67 proliferation index (PI) was estimated for each biopsy site from the MIB-1 stained sections. The response evaluation was performed after chemotherapy completion (6-8 cycles).
Results. All patients had one or more visualized lymphomatous lesions on 18F-FDG-PET/CT. The SUVmax of the whole-body (BmSUVmax) was higher than the SUVmax at biopsy site (BxSUVmax) (mean: 20.1 vs. 17.3, p < 0.01). The PI correlated with the BxSUVmax (p < 0.05). One week after chemotherapy, SUVmax, SUVsum, MTVwb, and MTBwb decreased significantly (p < 0.01, respectively), SUVsum, MTVwb and MTBwb at Exam II correlated with chemotherapy response at treatment completion (p < 0.05, respectively).
Conclusion. SUVmax is more accurate to detect tumor aggressiveness than biopsy in DLBCL, since BmSUVmax represents the most aggressive tumor of the patient. Interim PET/CT as early as one week after R-CHOP therapy predicts response. Thus, it could be used as a tool for guidance of risk stratification in DLBCL. |
| doi_str_mv | 10.3109/0284186X.2014.927074 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1555623666</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1555623666</sourcerecordid><originalsourceid>FETCH-LOGICAL-c408t-2845c5830cc8166249663bfafabf53bfbc415edf836dea9275e73d3855c2c4353</originalsourceid><addsrcrecordid>eNp9kEtPwzAQhC0EoqXwDxDKkUtaP2InvSBBVR5SJTgU1JvlOGuaKi9s59B_j6O2HDntHr7ZnRmEbgmeMoLnM0yzhGRiM6WYJNM5TXGanKExEZzElIrNORoPSDwwI3Tl3A5jTFnKL9GIJnOBeUbG6GupbLWPysaDLevoY7meLdZRZ6EotXdR1zofewvK19D4yILr2sZB4KOiNKYPa6XsN0RPsYaqiqp93W3bWl2jC6MqBzfHOUGfz8v14jVevb-8LR5XsU5w5uPgj2ueMax1RoQYbAmWG2VUbnhYcp0QDoXJmChAhYwcUlawjHNNdcI4m6D7w93Otj89OC_r0g1OVANt7yThnAvKRDg7QckB1bZ1zoKRXUis7F4SLIdG5alROTQqD40G2d3xQ5_XUPyJThUG4OEAlI1pba22oCq_1cqC3LW9bUL8_z_8Ar4ohPM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1555623666</pqid></control><display><type>article</type><title>Early interim PET/CT predicts post-treatment response in diffuse large B-cell lymphoma</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Taylor & Francis Journals Complete</source><source>Alma/SFX Local Collection</source><creator>Wu, Xingchen ; Pertovaara, Hannu ; Korkola, Pasi ; Vornanen, Martine ; Järvenpää, Ritva ; Dastidar, Prasun ; Eskola, Hannu ; Kellokumpu-Lehtinen, Pirkko-Liisa</creator><creatorcontrib>Wu, Xingchen ; Pertovaara, Hannu ; Korkola, Pasi ; Vornanen, Martine ; Järvenpää, Ritva ; Dastidar, Prasun ; Eskola, Hannu ; Kellokumpu-Lehtinen, Pirkko-Liisa</creatorcontrib><description>Abstract
Background. 18F-FDG-PET/CT has been widely used in the staging of malignant lymphomas, and accepted as a tool for response assessment. Among PET parameters, the most frequently studied is maximal standardized uptake value (SUVmax). Metabolic tumor burden (MTB) is a parameter in which both metabolic tumor volume (MTV) and tumor activity are integrated. Here, we analyzed the prognostic value of SUVmax, SUVsum (sum of the SUVmax), whole-body MTV (MTVwb) and MTBwb from baseline and interim PET/CT in patients with diffuse large B-cell lymphoma (DLBCL).
Material and methods. Twenty-nine patients with histologically proven DLBCL were imaged by PET/CT before treatment (Exam I), and one week after the first dose of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy (Exam II). Biopsy specimens were examined by an expert hematopathologist, the Ki-67 proliferation index (PI) was estimated for each biopsy site from the MIB-1 stained sections. The response evaluation was performed after chemotherapy completion (6-8 cycles).
Results. All patients had one or more visualized lymphomatous lesions on 18F-FDG-PET/CT. The SUVmax of the whole-body (BmSUVmax) was higher than the SUVmax at biopsy site (BxSUVmax) (mean: 20.1 vs. 17.3, p < 0.01). The PI correlated with the BxSUVmax (p < 0.05). One week after chemotherapy, SUVmax, SUVsum, MTVwb, and MTBwb decreased significantly (p < 0.01, respectively), SUVsum, MTVwb and MTBwb at Exam II correlated with chemotherapy response at treatment completion (p < 0.05, respectively).
Conclusion. SUVmax is more accurate to detect tumor aggressiveness than biopsy in DLBCL, since BmSUVmax represents the most aggressive tumor of the patient. Interim PET/CT as early as one week after R-CHOP therapy predicts response. Thus, it could be used as a tool for guidance of risk stratification in DLBCL.</description><identifier>ISSN: 0284-186X</identifier><identifier>EISSN: 1651-226X</identifier><identifier>DOI: 10.3109/0284186X.2014.927074</identifier><identifier>PMID: 24960581</identifier><language>eng</language><publisher>England: Informa Healthcare</publisher><subject><![CDATA[Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Cyclophosphamide - administration & dosage ; Doxorubicin - administration & dosage ; Female ; Fluorodeoxyglucose F18 ; Humans ; Lymphoma, Large B-Cell, Diffuse - diagnostic imaging ; Lymphoma, Large B-Cell, Diffuse - drug therapy ; Lymphoma, Large B-Cell, Diffuse - metabolism ; Lymphoma, Large B-Cell, Diffuse - pathology ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Positron-Emission Tomography - methods ; Prednisone - administration & dosage ; Radiopharmaceuticals ; Tomography, X-Ray Computed - methods ; Vincristine - administration & dosage]]></subject><ispartof>Acta oncologica, 2014-08, Vol.53 (8), p.1093-1099</ispartof><rights>2014 Informa Healthcare 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-2845c5830cc8166249663bfafabf53bfbc415edf836dea9275e73d3855c2c4353</citedby><cites>FETCH-LOGICAL-c408t-2845c5830cc8166249663bfafabf53bfbc415edf836dea9275e73d3855c2c4353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.3109/0284186X.2014.927074$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.3109/0284186X.2014.927074$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,61220,61401</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24960581$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Xingchen</creatorcontrib><creatorcontrib>Pertovaara, Hannu</creatorcontrib><creatorcontrib>Korkola, Pasi</creatorcontrib><creatorcontrib>Vornanen, Martine</creatorcontrib><creatorcontrib>Järvenpää, Ritva</creatorcontrib><creatorcontrib>Dastidar, Prasun</creatorcontrib><creatorcontrib>Eskola, Hannu</creatorcontrib><creatorcontrib>Kellokumpu-Lehtinen, Pirkko-Liisa</creatorcontrib><title>Early interim PET/CT predicts post-treatment response in diffuse large B-cell lymphoma</title><title>Acta oncologica</title><addtitle>Acta Oncol</addtitle><description>Abstract
Background. 18F-FDG-PET/CT has been widely used in the staging of malignant lymphomas, and accepted as a tool for response assessment. Among PET parameters, the most frequently studied is maximal standardized uptake value (SUVmax). Metabolic tumor burden (MTB) is a parameter in which both metabolic tumor volume (MTV) and tumor activity are integrated. Here, we analyzed the prognostic value of SUVmax, SUVsum (sum of the SUVmax), whole-body MTV (MTVwb) and MTBwb from baseline and interim PET/CT in patients with diffuse large B-cell lymphoma (DLBCL).
Material and methods. Twenty-nine patients with histologically proven DLBCL were imaged by PET/CT before treatment (Exam I), and one week after the first dose of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy (Exam II). Biopsy specimens were examined by an expert hematopathologist, the Ki-67 proliferation index (PI) was estimated for each biopsy site from the MIB-1 stained sections. The response evaluation was performed after chemotherapy completion (6-8 cycles).
Results. All patients had one or more visualized lymphomatous lesions on 18F-FDG-PET/CT. The SUVmax of the whole-body (BmSUVmax) was higher than the SUVmax at biopsy site (BxSUVmax) (mean: 20.1 vs. 17.3, p < 0.01). The PI correlated with the BxSUVmax (p < 0.05). One week after chemotherapy, SUVmax, SUVsum, MTVwb, and MTBwb decreased significantly (p < 0.01, respectively), SUVsum, MTVwb and MTBwb at Exam II correlated with chemotherapy response at treatment completion (p < 0.05, respectively).
Conclusion. SUVmax is more accurate to detect tumor aggressiveness than biopsy in DLBCL, since BmSUVmax represents the most aggressive tumor of the patient. Interim PET/CT as early as one week after R-CHOP therapy predicts response. Thus, it could be used as a tool for guidance of risk stratification in DLBCL.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antibodies, Monoclonal, Murine-Derived - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Cyclophosphamide - administration & dosage</subject><subject>Doxorubicin - administration & dosage</subject><subject>Female</subject><subject>Fluorodeoxyglucose F18</subject><subject>Humans</subject><subject>Lymphoma, Large B-Cell, Diffuse - diagnostic imaging</subject><subject>Lymphoma, Large B-Cell, Diffuse - drug therapy</subject><subject>Lymphoma, Large B-Cell, Diffuse - metabolism</subject><subject>Lymphoma, Large B-Cell, Diffuse - pathology</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Positron-Emission Tomography - methods</subject><subject>Prednisone - administration & dosage</subject><subject>Radiopharmaceuticals</subject><subject>Tomography, X-Ray Computed - methods</subject><subject>Vincristine - administration & dosage</subject><issn>0284-186X</issn><issn>1651-226X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtPwzAQhC0EoqXwDxDKkUtaP2InvSBBVR5SJTgU1JvlOGuaKi9s59B_j6O2HDntHr7ZnRmEbgmeMoLnM0yzhGRiM6WYJNM5TXGanKExEZzElIrNORoPSDwwI3Tl3A5jTFnKL9GIJnOBeUbG6GupbLWPysaDLevoY7meLdZRZ6EotXdR1zofewvK19D4yILr2sZB4KOiNKYPa6XsN0RPsYaqiqp93W3bWl2jC6MqBzfHOUGfz8v14jVevb-8LR5XsU5w5uPgj2ueMax1RoQYbAmWG2VUbnhYcp0QDoXJmChAhYwcUlawjHNNdcI4m6D7w93Otj89OC_r0g1OVANt7yThnAvKRDg7QckB1bZ1zoKRXUis7F4SLIdG5alROTQqD40G2d3xQ5_XUPyJThUG4OEAlI1pba22oCq_1cqC3LW9bUL8_z_8Ar4ohPM</recordid><startdate>20140801</startdate><enddate>20140801</enddate><creator>Wu, Xingchen</creator><creator>Pertovaara, Hannu</creator><creator>Korkola, Pasi</creator><creator>Vornanen, Martine</creator><creator>Järvenpää, Ritva</creator><creator>Dastidar, Prasun</creator><creator>Eskola, Hannu</creator><creator>Kellokumpu-Lehtinen, Pirkko-Liisa</creator><general>Informa Healthcare</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140801</creationdate><title>Early interim PET/CT predicts post-treatment response in diffuse large B-cell lymphoma</title><author>Wu, Xingchen ; Pertovaara, Hannu ; Korkola, Pasi ; Vornanen, Martine ; Järvenpää, Ritva ; Dastidar, Prasun ; Eskola, Hannu ; Kellokumpu-Lehtinen, Pirkko-Liisa</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-2845c5830cc8166249663bfafabf53bfbc415edf836dea9275e73d3855c2c4353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antibodies, Monoclonal, Murine-Derived - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Cyclophosphamide - administration & dosage</topic><topic>Doxorubicin - administration & dosage</topic><topic>Female</topic><topic>Fluorodeoxyglucose F18</topic><topic>Humans</topic><topic>Lymphoma, Large B-Cell, Diffuse - diagnostic imaging</topic><topic>Lymphoma, Large B-Cell, Diffuse - drug therapy</topic><topic>Lymphoma, Large B-Cell, Diffuse - metabolism</topic><topic>Lymphoma, Large B-Cell, Diffuse - pathology</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Positron-Emission Tomography - methods</topic><topic>Prednisone - administration & dosage</topic><topic>Radiopharmaceuticals</topic><topic>Tomography, X-Ray Computed - methods</topic><topic>Vincristine - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wu, Xingchen</creatorcontrib><creatorcontrib>Pertovaara, Hannu</creatorcontrib><creatorcontrib>Korkola, Pasi</creatorcontrib><creatorcontrib>Vornanen, Martine</creatorcontrib><creatorcontrib>Järvenpää, Ritva</creatorcontrib><creatorcontrib>Dastidar, Prasun</creatorcontrib><creatorcontrib>Eskola, Hannu</creatorcontrib><creatorcontrib>Kellokumpu-Lehtinen, Pirkko-Liisa</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Acta oncologica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wu, Xingchen</au><au>Pertovaara, Hannu</au><au>Korkola, Pasi</au><au>Vornanen, Martine</au><au>Järvenpää, Ritva</au><au>Dastidar, Prasun</au><au>Eskola, Hannu</au><au>Kellokumpu-Lehtinen, Pirkko-Liisa</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Early interim PET/CT predicts post-treatment response in diffuse large B-cell lymphoma</atitle><jtitle>Acta oncologica</jtitle><addtitle>Acta Oncol</addtitle><date>2014-08-01</date><risdate>2014</risdate><volume>53</volume><issue>8</issue><spage>1093</spage><epage>1099</epage><pages>1093-1099</pages><issn>0284-186X</issn><eissn>1651-226X</eissn><abstract>Abstract
Background. 18F-FDG-PET/CT has been widely used in the staging of malignant lymphomas, and accepted as a tool for response assessment. Among PET parameters, the most frequently studied is maximal standardized uptake value (SUVmax). Metabolic tumor burden (MTB) is a parameter in which both metabolic tumor volume (MTV) and tumor activity are integrated. Here, we analyzed the prognostic value of SUVmax, SUVsum (sum of the SUVmax), whole-body MTV (MTVwb) and MTBwb from baseline and interim PET/CT in patients with diffuse large B-cell lymphoma (DLBCL).
Material and methods. Twenty-nine patients with histologically proven DLBCL were imaged by PET/CT before treatment (Exam I), and one week after the first dose of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy (Exam II). Biopsy specimens were examined by an expert hematopathologist, the Ki-67 proliferation index (PI) was estimated for each biopsy site from the MIB-1 stained sections. The response evaluation was performed after chemotherapy completion (6-8 cycles).
Results. All patients had one or more visualized lymphomatous lesions on 18F-FDG-PET/CT. The SUVmax of the whole-body (BmSUVmax) was higher than the SUVmax at biopsy site (BxSUVmax) (mean: 20.1 vs. 17.3, p < 0.01). The PI correlated with the BxSUVmax (p < 0.05). One week after chemotherapy, SUVmax, SUVsum, MTVwb, and MTBwb decreased significantly (p < 0.01, respectively), SUVsum, MTVwb and MTBwb at Exam II correlated with chemotherapy response at treatment completion (p < 0.05, respectively).
Conclusion. SUVmax is more accurate to detect tumor aggressiveness than biopsy in DLBCL, since BmSUVmax represents the most aggressive tumor of the patient. Interim PET/CT as early as one week after R-CHOP therapy predicts response. Thus, it could be used as a tool for guidance of risk stratification in DLBCL.</abstract><cop>England</cop><pub>Informa Healthcare</pub><pmid>24960581</pmid><doi>10.3109/0284186X.2014.927074</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Antibodies, Monoclonal, Murine-Derived - administration & dosage Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Cyclophosphamide - administration & dosage Doxorubicin - administration & dosage Female Fluorodeoxyglucose F18 Humans Lymphoma, Large B-Cell, Diffuse - diagnostic imaging Lymphoma, Large B-Cell, Diffuse - drug therapy Lymphoma, Large B-Cell, Diffuse - metabolism Lymphoma, Large B-Cell, Diffuse - pathology Magnetic Resonance Imaging - methods Male Middle Aged Positron-Emission Tomography - methods Prednisone - administration & dosage Radiopharmaceuticals Tomography, X-Ray Computed - methods Vincristine - administration & dosage |
| title | Early interim PET/CT predicts post-treatment response in diffuse large B-cell lymphoma |
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