Prognostic value of whole-body dynamic (18)F-FDG PET/CT Patlak in diffuse large B-cell lymphoma

OBJECTIVE: This study aims to investigate the significance of interim whole-body dynamic (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) Patlak parameters for predicting the prognosis of patients with diffuse large B-cell lymphoma. To estimate the predictive value of the whole-body dynamic (18)F-FDG PET/CT Patlak parameter for 2-year progression-free survival (PFS) and 2-year overall survival (OS). METHODS: This study reports the findings of 67 patients with diffuse large B-cell lymphoma (DLBCL). These patients underwent interim whole-body dynamic (18)F-FDG PET/CT scans from June 2021 to January 2023 at the Department of Nuclear Medicine, First Affiliated Hospital of Anhui Medical University. The predictive values of maximum standard uptake value (SUV(max)), maximum of net glucose uptake rate (Ki(max)) and the predictive model combining Ki(max) and interim treatment response on the prognosis of patients was analyzed using receiver operating characteristic (ROC) curves. Kaplan-Meier survival curves and log-rank tests were used for survival analysis. Univariate and multivariate analyses were performed to screen for independent prognostic risk factors. RESULTS: After a median follow-up of 18 months, 21 patients (31.3%) experienced disease recurrence or death. The cut-off values for the SUV(max) and the Ki(max) were 6.1 and 0.13 μmol min(−1)·ml(−1), respectively. Ann Arbor stage, IPI, SUV(max), Ki(max) and interim treatment response were associated with PFS and OS in the univariate analysis. However, only Ki(max) and interim treatment response were independent influences on PFS and OS in multivariate analysis. CONCLUSION: Interim whole-body dynamic (18)F-FDG PET/CT Patlak imaging has significant prognostic value in patients with DLBCL. Among them, the interim dynamic parameter Ki(max) showed the best predictive value for prognosis compared with the interim SUV(max) and interim treatment response. The predictive model established by Ki(max) and the interim treatment response allowed for the accurate stratification of the prognostic risk of DLBCL.