TY - JOUR T1 - Early <sup>18</sup>F-FDG PET for Prediction of Prognosis in Patients with Diffuse Large B-Cell Lymphoma: SUV-Based Assessment Versus Visual Analysis JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1626 LP - 1632 DO - 10.2967/jnumed.107.042093 VL - 48 IS - 10 AU - Chieh Lin AU - Emmanuel Itti AU - Corinne Haioun AU - Yolande Petegnief AU - Alain Luciani AU - Jehan Dupuis AU - Gaetano Paone AU - Jean-Noël Talbot AU - Alain Rahmouni AU - Michel Meignan Y1 - 2007/10/01 UR - http://jnm.snmjournals.org/content/48/10/1626.abstract N2 - The purpose of this study was to assess the prognostic value of early 18F-FDG PET using standardized uptake value (SUV) compared with visual analysis in patients with diffuse large B-cell lymphoma (DLBCL). Methods: Ninety-two patients with newly diagnosed DLBCL underwent 18F-FDG PET prospectively before and after 2 cycles of chemotherapy (at midtherapy). Maximum SUV (SUVmax) and mean SUV (SUVmean) normalized to body weight and body surface area, as well as tumor-to-normal ratios, were computed on the most intense uptake areas. The SUVs, tumor-to-normal ratios, and their changes over time were compared with visual analysis for predicting event-free survival (EFS) and overall survival, using receiver-operating-characteristic (ROC) analysis. Survival curves were estimated with Kaplan–Meier analysis and compared using the log-rank test. Results: With visual analysis, the accuracy of early PET to predict EFS was 65.2%. The 2-y estimate for EFS was 51% (95% confidence interval [CI], 34%–68%) in the PET-positive group compared with 79% (95% CI, 68%–90%) in the PET-negative group (P = 0.009). An optimal cutoff value of 65.7% SUVmax reduction from baseline to midtherapy obtained from ROC analysis yielded an accuracy of 76.1% to predict EFS. The 2-y estimate for EFS was 21% (95% CI, 0%–42%) in patients with SUVmax reduction ≤ 65.7% compared with 79% (95% CI, 69%–88%) in those with reduction &gt; 65.7% (P &lt; 0.0001). Fourteen patients considered as positive on visual analysis could have been reclassified as good responders. Conclusion: SUV-based assessment of therapeutic response during first-line chemotherapy improves the prognostic value of early 18F-FDG PET compared with visual analysis in DLBCL. ER -