Prognostic role of baseline 18F-FDG PET/CT metabolic parameters and relevant clinical factors in peripheral T-cell lymphoma, not otherwise specified / 中华核医学与分子影像杂志

ABSTRACT

Objective:To explore the prognostic role of baseline 18F-FDG PET/CT metabolic parameters for patients with peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). Methods:From February 2010 to January 2019, 47 PTCL-NOS patients (29 males, 18 females, age (59.7±13.6) years) from Nanjing Drum Tower Hospital were retrospectively enrolled. Each patient underwent baseline 18F-FDG PET/CT imaging before treatment. The total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) were computed by using the margin threshold of 41% SUV max. Kaplan-Meier survival analysis, univariate and multivariate Cox proportional hazards regression models were used to evaluate progression-free survival (PFS) and overall survival (OS). Results:Over the follow-up of 5-119 months, 25 patients had disease progression, including 24 deaths. SUV max (hazard ratio ( HR)=8.581, 95% CI 1.950-37.764, P=0.004), TMTV( HR=9.677, 95% CI 3.521-26.593, P<0.001), TLG( HR=3.647, 95% CI 1.245-10.682, P<0.001) and prognostic index for T-cell lymphoma (PIT; HR=4.593, 95% CI 1.792-11.773, P=0.002) were significant predictors of PFS and OS( HR=8.720, 95% CI 1.982-83.354, P=0.004; HR=9.325, 95% CI 3.423-25.408, P<0.001; HR=3.439, 95% CI 1.170-10.110, P<0.001; HR=4.437, 95% CI 1.728-11.393, P=0.002). After multivariate analysis, TMTV was the independent predictor of PFS ( HR=4.371, 95% CI 1.066-16.541, P<0.001) and OS ( HR=4.978, 95% CI 1.123-21.329, P<0.001). The substratification analysis showed that patients with high TMTV(≥168.3 cm 3) had worse prognosis than those with low TMTV (<168.3 cm 3) for PFS ( χ2=14.60, P<0.001) and OS ( χ2=16.81, P<0.001) in low PIT (0-1) group, while patients with high TMTV had worse prognosis than those with low TMTV for PFS ( χ2=4.09, P=0.043) in high PIT (≥2) group. Conclusions:Baseline PET/CT metabolic parameters including SUV max, TMTV, TLG and PIT are able to predict survival in PTCL-NOS patients. TMTV is the independent predictor of PFS and OS, which can substratify PTCL-NOS patients in PIT group.