@article {Cottereau589, author = {Anne-S{\'e}gol{\`e}ne Cottereau and Tarec Christoffer El-Galaly and St{\'e}phanie Becker and Florence Broussais and Lars Jelstrup Petersen and Christophe Bonnet and John O. Prior and Herv{\'e} Tilly and Martin Hutchings and Olivier Casasnovas and Michel Meignan}, title = {Predictive Value of PET Response Combined with Baseline Metabolic Tumor Volume in Peripheral T-Cell Lymphoma Patients}, volume = {59}, number = {4}, pages = {589--595}, year = {2018}, doi = {10.2967/jnumed.117.193946}, publisher = {Society of Nuclear Medicine}, abstract = {Peripheral T-cell lymphoma (PTCL) is a heterogeneous group of aggressive non-Hodgkin lymphomas with poor outcomes on current therapy. We investigated whether response assessed with PET/CT combined with baseline total metabolic tumor volume (TMTV) could detect early relapse or refractory disease. Methods: From 7 European centers, 140 patients with nodal PTCL who underwent baseline PET/CT were selected. Forty-three had interim PET (iPET) performed after 2 cycles (iPET2), 95 had iPET performed after 3 or 4 cycles (iPET3/4), and 96 had end-of-treatment PET (eotPET). Baseline TMTV was computed with a 41\% SUVmax threshold, and PET response was reported using the Deauville 5-point scale. Results: With a median of 43 mo of follow-up, the 2-y progression-free survival (PFS) and overall survival (OS) were 51\% and 67\%, respectively. iPET2-positive patients (Deauville score >= 4) had a significantly worse outcome than iPET2-negative patients (P \< 0.0001, hazard ratio of 6.8 for PFS; P \< 0.0001, hazard ratio of 6.6 for OS). The value of iPET3/4 was also confirmed for PFS (P \< 0.0001) and OS (P \< 0.0001). The 2-y PFS and OS for iPET3/4-positive (n = 28) and iPET3/4-negative (n = 67) patients were 16\% and 32\% versus 75\% and 85\%, respectively. The eotPET results also reflected patient outcome. A model combining TMTV and iPET3/4 stratified the population into distinct risk groups (TMTV <= 230 cm3 and iPET3/4-negative [2-y PFS/OS, 79\%/85\%]; TMTV \> 230 cm3 and iPET3/4-negative [59\%/84\%]; TMTV <= 230 cm3 and iPET3/4-positive [42\%/50\%]; TMTV \> 230 cm3 and iPET3/4-positive [0\%/18\%]). Conclusion: iPET response is predictive of outcome and allows early detection of high-risk PTCL patients. Combining iPET with TMTV improves risk stratification in individual patients.}, issn = {0161-5505}, URL = {https://jnm.snmjournals.org/content/59/4/589}, eprint = {https://jnm.snmjournals.org/content/59/4/589.full.pdf}, journal = {Journal of Nuclear Medicine} }