Correlation of pretreatment (18)F-FDG uptake with clinicopathological factors and prognosis in patients with newly diagnosed diffuse large B-cell lymphoma

OBJECTIVES: The aim of this study is to determine the correlation of pretreatment fluorine-18 fluorodeoxyglucose uptake with clinicopathological factors and its prognostic value in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL). PATIENTS AND METHODS: A cohort of 162 patients with newly diagnosed DLBCL who had undergone pretreatment PET/computed tomography was retrospectively reviewed. The relationship of pretreatment maximum standard uptake value (SUV(max)) with clinical factors, molecular markers, and efficacy was evaluated. The value of SUV(max) in predicting progression-free survival (PFS) and overall survival was analyzed. RESULTS: In all, 72.9% of the patients received R-CHOP treatment; the rest received CHOP chemotherapy. The median follow-up duration was 30 months (range, 4–124 months). The median SUV(max) was 12.2 (range, 1.7–42.7). SUV(max) between groups differed significantly with respect to each of International Prognostic Index (IPI) factors, except for age and performance status. High SUV(max) was associated with high Ki-67 and Glut-3 protein expression, but not with Glut-1. Complete remission rate differed significantly between the low (SUV(max)≤9.0) and the high SUV(max) (SUV(max)>9.0) groups (91.7 vs. 61.1%, P=0.000). Patients with low SUV(max) showed favorable survival (3-year PFS: 92.2 vs. 63.6%, P=0.000; 3-year overall survival: 95.5 vs. 78.3%, P=0.003). On multivariate analyses, SUV(max) predicted PFS independent of revised-IPI (SUV(max): P=0.011, hazard ratio 4.784; revised-IPI: P=0.004, hazard ratio 2.551). CONCLUSION: Pretreatment SUV(max) was associated with clinicopathological factors, efficacy, and survival outcome. A novel prognostic model on the basis of IPI score/pretreatment SUV(max) might be useful for risk stratification of patients with newly diagnosed DLBCL Video abstract: http://links.lww.com/NMC/A55.