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SUVmax reduction improves early prognosis value of interim positron emission tomography scans in diffuse large B-cell lymphoma.

Author(s): Casasnovas RO, Meignan M, Berriolo-Riedinger A, Bardet S, Julian A, Thieblemont C, Vera P, Bologna S, Briere J, Jais JP, Haioun C, Coiffier B, Morschhauser F

Affiliation(s): Hopital Le Bocage, Dijon, France. casasnovas@chu-dijon.fr

Publication date & source: 2011-07-07, Blood., 118(1):37-43. Epub 2011 Apr 25.

Publication type: Clinical Trial, Phase II; Comparative Study; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

The prognostic value of interim positron emission tomography (PET) interpreted according to visual criteria is a matter of debate in diffuse large B-cell lymphoma (DLBCL). Maximal standardized uptake value reduction (DeltaSUVmax) may better predict outcome. To compare the prognostic value of both methods, we analyzed PET done at baseline (PET0) and after 2 (PET2) and 4 (PET4) cycles in 85 patients with high-risk DLBCL enrolled on a prospective multicenter trial. All images were centrally reviewed and interpreted visually according to the International Harmonization Project criteria and by computing DeltaSUVmax between PET0 and PET2 (DeltaSUVmaxPET0-2) or PET4 (DeltaSUVmaxPET0-4). Optimal cutoff to predict progression or death was 66% for DeltaSUVmaxPET0-2 and 70% for DeltaSUVmaxPET0-4. Outcomes did not differ significantly whether PET2 and PET4 were visually positive or negative. Inversely, DeltaSUVmaxPET0-2 analysis (> 66% vs </= 66%) identified patients with significantly different 2-year progression-free survival (77% vs 57%; P = .0282) and overall survival (93% vs 60%; P < .0001). DeltaSUVmaxPET0-4 analysis (> 70% vs </= 70%) seemed even more predictive for 2-year progression-free survival (83 vs 40%; P < .0001) and overall survival (94% vs 50%; P < .0001). DeltaSUVmax analysis of sequential interim PET is feasible for high-risk DLBCL and better predicts outcome than visual analysis. The trial was registered at http://clinicaltrials.gov as NCT00498043.

Page last updated: 2011-12-09

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