The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Prognostic significance of sequential 18F-FDG PET/CT during frontline treatment of peripheral T cell lymphomas

  • Ga-Young Song (Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Sung-Hoon Jung (Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Seo-Yeon Ahn (Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Mihee Kim (Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Jae-Sook Ahn (Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Je-Jung Lee (Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Hyeoung-Joon Kim (Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Jang Bae Moon (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Su Woong Yoo (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Seong Young Kwon (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Jung-Joon Min (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Hee-Seung Bom (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Sae-Ryung Kang (Department of Nuclear Medicine, Chonnam National University Hwasun Hospital, Chonnam National University Medical School) ;
  • Deok-Hwan Yang (Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School)
  • Received : 2023.08.03
  • Accepted : 2023.10.19
  • Published : 2024.03.01
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Abstract

Background/Aims: The prognostic significance of 18F-fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET/CT) in peripheral T-cell lymphomas (PTCLs) are controversial. We explored the prognostic impact of sequential 18F-FDG PET/CT during frontline chemotherapy of patients with PTCLs. Methods: In total, 143 patients with newly diagnosed PTCLs were included. Sequential 18F-FDG PET/CTs were performed at the time of diagnosis, during chemotherapy, and at the end of chemotherapy. The baseline total metabolic tumor volume (TMTV) was calculated using the the standard uptake value with a threshold method of 2.5. Results: A baseline TMTV of 457.0 cm3 was used to categorize patients into high and low TMTV groups. Patients with a high TMTV had shorter progression-free survival (PFS) and overall survival (OS) than those with a low TMTV (PFS, 9.8 vs. 26.5 mo, p = 0.043; OS, 18.9 vs. 71.2 mo, p = 0.004). The interim 18F-FDG PET/CT response score was recorded as 1, 2-3, and 4-5 according to the Deauville criteria. The PFS and OS showed significant differences according to the interim 18F-FDG PET/CT response score (PFS, 120.7 vs. 34.1 vs. 5.1 mo, p < 0.001; OS, not reached vs. 61.1 mo vs. 12.1 mo, p < 0.001). Conclusions: The interim PET/CT response based on visual assessment predicts disease progression and survival outcome in PTCLs. A high baseline TMTV is associated with a poor response to anthracycline-based chemotherapy in PTCLs. However, TMTV was not an independent predictor for PFS in the multivariate analysis.

Keywords

Acknowledgement

This study was supported by grants from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (no. HR20C0021), and the Chonnam National University Hwasun Hospital Research Institute of Clinical Medicine (no. HCRI20011).

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