Prognostic Value of Total Tumor Burden (TTB) Derived from 18F-FDG PET in Patients with Aggressive Non-Hodgkin Lymphoma

Ziel/Aim: Our goal was to investigate if the total tumor burden (TTB) can improve the prognostic value of PET in aggressive lymphoma.

Methodik/Methods: PET data from the PETAL Trial [1] were re-evaluated. Image data as well as maximum baseline SUV and maximum interim SUV (after 2 cycles of R-CHOP) were provided by the PETAL-Trial coordinators. So far, 234 patients could be included. In the corresponding baseline PET all affected lesions were delineated with a previously trained neural network. All delineations were visually confirmed or corrected by an experienced nuclear medicine specialist, if necessary. From the resulting VOIs TTB was derived. Survival analyses with respect to overall survival (OS) and event free survival (EFS) were performed for baseline SUVmax, ΔSUVmax (> -66%), and TTB.

Ergebnisse/Results: Survival analyses revealed ΔSUVmax and TTB as prognostic factors for both OS (P<0001 and P<0.025, respectively) and EFS (p<0.001 and p<0.001, respectively). Baseline SUVmax did not show a significant effect for neither.

In multivariate analysis, ΔSUVmax (p<0.001) and TTB (p=0.037) remained significant for both endpoints indicating their independent prognostic value.

Schlussfolgerungen/Conclusion: Our results show that TTB adds independent prognostic information to ΔSUVmax, which increases the overall prognostic value of PET in this cohort. Further investigations are necessary to confirm these preliminary results.

Publication History

Article published online:
12 March 2025

• References

• 1 PETAL Trial Investigators. Dührsen U, Müller S, Hüttmann A. Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas (PETAL): A Multicenter, Randomized Phase III Trial. J Clin Oncol 2018; 36 (20) 2024-2034