Prognostic superiority of the National Comprehensive Cancer Network International Prognostic Index over pretreatment whole-body volumetric-metabolic FDG- PET/ CT metrics in diffuse large B-cell lymphoma.

Purpose This study aimed to determine the prognostic value of whole-body maximum standardized uptake value ( SUVmax), whole-body metabolic tumor volume ( MTV), and whole-body total lesion glycolysis ( TLG) at pretreatment 18F-fluoro-2-deoxy- d-glucose positron emission tomography/computed tomography ( FDG- PET/ CT) in patients with newly diagnosed diffuse large B-cell lymphoma ( DLBCL). Materials and Methods Seventy-three patients with newly diagnosed DLBCL who had undergone FDG- PET/ CT before rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, and prednisolone (R- CHOP) immunochemotherapy were retrospectively included. All FDG-avid lesions in each patient were segmented using semi-automated software to calculate whole-body SUVmax, whole-body MTV, and whole-body TLG values. Cox regression analyses were used to determine the associations of whole-body SUVmax, whole-body MTV, whole-body TLG, and dichotomized National Comprehensive Cancer Network International Prognostic Index ( NCCN- IPI) risk group (low risk vs. high risk) with progression-free survival ( PFS) and overall survival ( OS). Results On univariate Cox regression analysis, only the NCCN- IPI was a significant predictor of PFS ( P = 0.024), and only the NCCN- IPI and whole-body MTV were significant predictors of OS ( P = 0.039 and P = 0.043, respectively). In the multivariate Cox proportional hazards model, only the NCCN- IPI remained an independent predictive factor of PFS ( P = 0.024) and OS ( P = 0.039). Conclusion Whole-body SUVmax, whole-body MTV, and whole-body TLG do not provide any prognostic information in DLBCL beyond that which can already be obtained by the NCCN- IPI. Therefore, the NCCN- IPI remains the most important prognostic tool in this disease. [ABSTRACT FROM AUTHOR]