Open AccessRole of 18F-Fluorodeoxyglucose–Positron Emission Tomography/Computed Tomography Imaging in the Prediction of Prognosis in Patients With Indolent Lymphoma: Prospective Study
Author(s) -
Nawal AlShehry,
Shanker Raja,
Syed Ziauddin A. Zaidi,
F. Alghmlas,
Ibraheem Motabi,
Shahid Iqbal,
Ahmad Butt,
Hassan Alshehri,
Imran K. Tailor,
Syed Altaf,
Mubarak S. AlGhamdi,
Mohammed Marie,
Mansour Alfayez,
Kamal Al Zahrani,
Mohammed Dwaimah,
Tahani Al-Halouli,
Wafaa Al-Shakweer,
Maied Zaher AlShehery,
Abdul Rehman Zia Zaidi,
Atta Munawar Gill,
Belal Albtoosh,
Musab Ahmed
Publication year - 2021
Publication title -
jmir formative research
Language(s) - English
Resource type - Journals
ISSN - 2561-326X
DOI - 10.2196/24936
Subject(s) - medicine , positron emission tomography , standardized uptake value , nuclear medicine , lymphoma , fluorodeoxyglucose , chemoimmunotherapy , prospective cohort study , pet ct , radiology , rituximab
Background The role of fluorodeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) in indolent lymphoma has been minimally studied. Objective This study aims to assess the value of FDG-PET/CT in predicting the prognosis of indolent lymphoma. Methods We prospectively recruited 42 patients with indolent lymphoma. A total of 2 patients were excluded, and 40 underwent baseline PET/CT and follow-up at various time points. A total of 9 patients were observed only, 7 received 4 doses of rituximab alone, and 24 received chemoimmunotherapy. Metabolic response on follow-up PET/CT was assessed using the maximum standardized uptake value (SUVmax) and Deauville criteria (DC). We aimed to obtain the best SUVmax and DC to predict optimal survival rates, risk stratification, and optimize therapeutic strategies. The mean follow-up from the initial diagnosis was 33.83 months. Results SUVmax <4.35 at interim PET/CT provided the best discrimination, with a progression-free survival (PFS) of 100% and a median survival time of 106.67 months compared with SUVmax ≥4.35 (P=.04), which had a PFS of 43.8% and a median survival time of 50.17 months. This cutoff was also valuable in predicting overall survival at baseline, that is, 100% overall survival with baseline SUVmax <4.35, versus 58.4% for SUVmax ≥4.35 (P=.13). The overall survival of patients with a baseline DC score <3.0 was 100%, with a median overall survival of 106.67 months. Conclusions We demonstrated the utility of PET/CT in indolent lymphomas. SUVmax (<4.35 vs ≥4.35) on interim PET/CT performed best in predicting PFS.