Article Figures & Data
Figures
- FIGURE 1.
Consort diagram and clinical outcome of enrolled patients.
- FIGURE 2.
Images of representative 18F-FLT PET scans. A 39-y-old woman with DLBL with involvement of multiple cervical lymph nodes (SUVmax, 7.7) achieved CR after induction chemotherapy. However, her interim 18F-FLT PET scan showed residual uptake (SUVmax, 4.6). She experienced relapse 16 mo after induction therapy and subsequently died because of disease progression. Corresponding sections of PET/CT fusion (A), axial (B), and maximum-intensity-projection 18F-FLT PET images (C) at different time points show regression of lymphoma. Nonspecific 18F-FLT uptake of bone was subtracted (B and C) to compare the mild residual 18F-FLT uptake after treatment. Subtraction was performed only in this figure.
- FIGURE 3.
Kaplan–Meier estimates of PFS and OS according to interim 18F-FLT PET (A and B) and final 18F-FLT PET (C and D) response analysis using SUVmax cutoff. There were significant differences in PFS and OS between 18F-FLT PET SUVmax–negative versus –positive patients (all P < 0.001).
- FIGURE 4.
Kaplan–Meier estimates of PFS (A) and OS (B) according to type of responses. Patients who achieved PET CR after only 1 cycle of chemotherapy showed better PFS and OS than others (P < 0.001). Slow responders who were interim 18F-FLT PET–positive and final 18F-FLT PET–negative were also associated with poor PFS and OS.
Tables
Demographic n = 61 Age (y) Median 57 Range 29–80 Sex Male 36 (59) Female 25 (41) Ann Arbor Stage I–II 41 (67.2) III–IV 20 (32.8) B symptom 7 (11.5) Extranodal involvement ≥ 2 9 (14.8) Bone marrow involvement 3 (4.9) Lactate dehydrogenase* (IU/mL) Mean 239 Range 122–1,829 IPI Low 37 (60.7) Low-intermediate 11 (18) High-intermediate 11 (18) High 2 (3.3) Ki 67 (%) Median 50 Range 5–95 Diagnosis DLBL 50 (82) Mantle cell lymphoma 4 (6.6) Follicular lymphoma 1 (1.6) Burkitt lymphoma 1 (1.6) Extranodal natural killer/T cell lymphoma, nasal type 4 (6.6) Peripheral T cell lymphoma, NOS 1 (1.6) ↵* Reference range for lactate dehydrogenase is 101–202 IU/mL.
Data in parentheses are percentages.
- TABLE 2
AUC Values of 18F-FLT Uptake for Disease Progression or Death in Patients with NHL
SUVmax SUVmean 18F-FLT PET PFS OS PFS OS Pre 0.491 0.546 0.497 0.561 Interim 0.841 0.834 0.842 0.824 Final 0.706 0.669 0.709 0.674 - TABLE 3
Multivariate Analysis of Interim 18F-FLT PET/CT Response by SUVmax for Disease Progression and Survival
PFS OS Variable Hazard ratio 95% confidence interval P Hazard ratio 95% confidence interval P Age (y) 1.04 1.00–1.09 0.074 1.03 0.97–1.08 0.343 Sex (female) 2.01 0.55–7.35 0.290 5.34 1.00–28.65 0.051 Ann Arbor Stage (III–IV) 1.86 0.39–8.89 0.435 — — — B symptom (present) 2.65 0.81–8.64 0.107 3.28 0.97–11.04 0.055 Extranodal involvement (≥2 sites) 2.09 0.49–8.96 0.320 — — — Bone marrow involvement (present) 6.70 1.16–38.85 0.034 — — — Interim SUVmax* (positive†) 7.82 1.65–36.96 0.009 7.05 1.47–33.77 0.014
Supplemental Data
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