Optimizing the prognostic capacity of baseline 18F-FDG PET/CT metabolic parameters in extranodal natural killer/T-cell lymphoma by using relative and absolute thresholds

oleh: Ying-Ming Zhu, Pan Peng, Xin Liu, Shu-Nan Qi, Shu-Lian Wang, Hui Fang, Yong-Wen Song, Yue-Ping Liu, Jing Jin, Ning Li, Ning-Ning Lu, Hao Jing, Yuan Tang, Bo Chen, Wen-Wen Zhang, Yi-Rui Zhai, Yong Yang, Bin Liang, Rong Zheng, Ye-Xiong Li

Format: Article
Diterbitkan: Elsevier 2024-02-01

Deskripsi

Objectives: To investigate the prognostic capacity of baseline 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) metabolic parameters in extranodal natural killer/T-cell lymphoma (ENKTCL), and the influence of relative thresholds (RT) and absolute thresholds (AT) selection on prognostic capacity. Materials and methods: Metabolic tumor volume (MTV)-based parameters were defined using RTs (41 % or 25 % of maximum standardized uptake value [SUVmax]), ATs (SUV 2.5, 3.0, 4.0, or mean liver uptake) in 133 patients. Metabolic parameters were classified into avidity-related parameters (SUVmax, mean SUV [SUVmean], standard deviation of SUV [SUVsd]), volume-related parameters (RT-MTV), and avidity- and volume-related parameters (total lesion glycolysis [TLG] and AT-MTV). The prognostic capacity of the metabolic parameters and the effects of different threshold types (RT vs. AT) were evaluated. Results: All metabolic parameters were moderately associated with prognosis. However, the area under the receiver operating characteristic curve of MTV and TLG was slightly higher than that of avidity-related parameters for predicting 5-year progression-free survival (PFS) (0.614–0.705 vs. 0.563–0.609) and overall survival (OS) (0.670–0.748 vs. 0.562–0.593). Correlations of MTV and avidity-related parameters differed between RTs (r < 0.06, P = 0.324–0.985) and ATs (r 0.56–0.84, P ≤ 0.001). AT-MTV was the optimal predictor for PFS and OS, while RT-TLG was the optimal predictor for PFS, and the combination of RT-MTV with SUVmax was the optimal predictor for OS. Conclusion: The incorporation of volume and avidity significantly improved the prognostic capacity of PET in ENKTCL. Composite parameters that encompassed both avidity and volume were recommended.