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J Nucl Med. 2008; 49 (Supplement 1):255P
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General Clinical Specialties: General Practice-Oncology

General Practice-Oncology Posters

The predictive value of the FDG-PET after the first cycle of chemotherapy in patients with diffuse large B cell lymphoma

Byung Hyun Byun1, Gi Jeong Cheon1, Hye Jin Kang2, Baek-Yeol Ryoo2, Sung Hyun Yang2, Chang Woon Choi1 and Sang Moo Lim1

1 Department of Nuclear Medicine; 2 Internal Medicine, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea

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Objectives: To evaluate the predictive performance of the early interim F-18-FDG PET in patients with DLBL using diverse PET parameters.

Methods: FDG PET was performed in 34 newly diagnosed DLBL patients at pre- and 5 days after chemotherapy. On each PET scan, we visually scored the hypermetabolism by 5-point scale and measured the maximum SUV in every 18 regional LN groups, organs, and bone marrow. Then, we calculated the summed visual score(SS) and the summed SUV (SUVsum) in every PET scan. The highest SUV of each PET data set was defined as SUVmax. Then, we acquired the decrements of PET parameters after the 1st cycle of chemotherapy, and calculated the ROC curves for therapeutic response after the completion of chemotherapy (CR or not). Progression-free survival (PFS) was compared among PET and clinical parameters-assigned response designations by Kaplan-Meier analysis.

Results: Initial Ann Arbor stages were stage I in 3, II in 9, III in 12, and IV in 10, and median follow up period was 26months. The optimal SUVmax reduction criterion for non-CR of was <=50.1%. Univariate analysis demonstrated that PFS is reduced in those with SUVmax reduction<=50.1% (p=0.018) and increased LDH (p=0.040). PFS did not correlate with the SS or SUVsum reduction, positive PET (residual tumor foci in post-treatment PET), or other clinical parameters (p>0.05). Multivariate analysis demonstrated that the single strongest predictor of PFS was SUVmax reduction (p=0.048).

Conclusions: FDG-PET after the 1st cycle of chemotherapy could predict the prognosis of DLBL patients. Prognostic value was improved by using SUVmax reduction which reflected the metabolic suppression after chemotherapy.





This Article
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Right arrow Email this article to a friend
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Right arrow Alert me to new issues of the journal
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Google Scholar
Right arrow Articles by Byun, B. H.
Right arrow Articles by Lim, S. M.
PubMed
Right arrow Articles by Byun, B. H.
Right arrow Articles by Lim, S. M.