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18F-FDG cerebellum/liver index as a prognostic factor for progression-free survival in diffuse large B-cell lymphoma

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Abstract

Objective

18F-FDG PET/CT provides valuable informations regarding the prognosis of DLBCL. The aim of this study is to test a novel index based on cerebellar uptake to predict progression free survival in DLBCL patients.

Methods

Data from patients with de novo DLBCL between January 2011 and December 2018 were retrospectively collected and PFS was determined. The conventional PET parameters (SUVmax and total metabolic tumor volume) and the CLIP, corresponding to the ratio of the cerebellum SUVmax over the liver SUVmean, were extracted from baseline 18F-FDG PET.

Results

Ninety-five patients were included. When using a threshold of 3.24, CLIP was a significant predictor of PFS on univariate analysis (HR 3.4, p < 0.001) with different 5-year survival rates: 68% (CLIP ≥ 3.24) versus 32% (CLIP < 3.24). Multivariate analysis confirmed the prognostic value of CLIP, as it is one of the two factors remaining significant with β2-microglobulin (HR 2.1 and 2.5 respectively, p = 0.04 and p = 0.03). A score associating β2-microglobulin and CLIP allowed to separate the population into three groups of different outcome in terms of 5-year PFS: low risk (80%), intermediate risk (42%) and high risk (17%).

Conclusions

The CLIP derived from pre-therapeutic 18F-FDG PET seems to be an interesting predictive marker of PFS in DLBCL treated by immunochemotherapy.

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Authors and Affiliations

  1. Médecine Nucléaire, Institut Godinot, 1 rue du Général Koenig, 51726, Reims Cedex, France

    David Morland, Ghali Zizi, François Godard & Dimitri Papathanassiou

  2. Laboratoire de Biophysique, UFR de Médecine, Université de Reims Champagne-Ardenne, Reims, France

    David Morland & Dimitri Papathanassiou

  3. CReSTIC (Centre de Recherche en Sciences et Technologies de l’Information et de la Communication), EA 3804, Université de Reims Champagne-Ardenne, Reims, France

    David Morland, Christine Hoeffel & Dimitri Papathanassiou

  4. Hématologie Clinique, CHU de Reims, Reims, France

    Anne-Cécile Gauchy, Alain Delmer & Eric Durot

  5. Radiologie, CHU de Reims, Reims, France

    Carole Durot & Christine Hoeffel

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  1. David Morland
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Correspondence to David Morland.

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Morland, D., Zizi, G., Godard, F. et al. 18F-FDG cerebellum/liver index as a prognostic factor for progression-free survival in diffuse large B-cell lymphoma. Ann Nucl Med 35, 785–793 (2021). https://doi.org/10.1007/s12149-021-01609-4

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  • DOI: https://doi.org/10.1007/s12149-021-01609-4

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