RT Journal Article
SR Electronic
T1 Predictive Value of PET Response Combined with Baseline Metabolic Tumor Volume in Peripheral T-Cell Lymphoma Patients
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 589
OP 595
DO 10.2967/jnumed.117.193946
VO 59
IS 4
A1 Anne-Ségolène Cottereau
A1 Tarec Christoffer El-Galaly
A1 Stéphanie Becker
A1 Florence Broussais
A1 Lars Jelstrup Petersen
A1 Christophe Bonnet
A1 John O. Prior
A1 Hervé Tilly
A1 Martin Hutchings
A1 Olivier Casasnovas
A1 Michel Meignan
YR 2018
UL http://jnm.snmjournals.org/content/59/4/589.abstract
AB 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.