Prognosis prediction in non-Hodgkin lymphoma by assessing lymphoid organs uptake patterns using baselineF-FDG PET/CT.

in International journal of cancer by Jie Ding, Xinwei Cheng, Haiyan Wang, Yu Sun, Yihong Yang, Na Qi, Yan Jiang, Xing Chen, Qingyuan Meng, Zhiwen You, Jianjuan Jiang, Jun Zhao

TLDR

  • The study explored the relationship between lymphoid organs' metabolic activity and treatment response in non-Hodgkin lymphoma patients, finding that increased activity is associated with poor prognosis.
  • The results suggest that incorporating lymphoid organs' metabolic assessment into clinical practice could improve treatment outcomes.

Abstract

The prognostic implications of lymphoid organs (LOs) involvement in untreated non-Hodgkin lymphoma (NHL) patients remain underexplored. This study aims to explore the significance of LOs metabolic activity, assessed viaF-FDG PET/CT, in predicting the early treatment response and prognosis of NHL patients. A retrospective analysis was conducted onF-FDG PET/CT imaging data of untreated NHL patients from March 2016 to December 2023. Metabolic activity levels of LOs were evaluated and scored. Prognostic parameters included the international prognostic index (IPI), progression-free survival (PFS), overall survival (OS), and the interim efficacy evaluation. The median follow-up time was 15 months. The survival analysis was conducted using Kaplan-Meier and Cox regression methods. We included a total of 125 NHL patients (63 ± 12 years) with baselineF-FDG PET/CT scans. Based on the metabolic scores of LOs, patients were divided into three groups: 36 (28.8%) in the low metabolism group, 64 (51.2%) in the intermediate metabolism group, and 25 (20.0%) in the high metabolism group. LOs metabolic scores emerged as an independent prognostic factor. Patients with high metabolic activity in LOs had significantly shorter PFS and OS compared to those with lower activity (OS HR = 4.56; PFS HR = 3.87; p <0.01). The combination of LOs metabolism and extra-LOs tumor burden can further stratify the risk in NHL patients. Metabolic activity in LOs inF-FDG is a vital prognostic indicator and may predict early treatment response in NHL patients. The incorporation of LOs metabolic assessment into clinical practice could enable more accurate prognosis and tailored treatment strategies.

Overview

  • The study aims to explore the significance of lymphoid organs (LOs) metabolic activity in predicting the early treatment response and prognosis of non-Hodgkin lymphoma (NHL) patients using F-FDG PET/CT imaging.
  • A retrospective analysis was conducted on F-FDG PET/CT imaging data of untreated NHL patients from March 2016 to December 2023.
  • The study included a total of 125 NHL patients with baseline F-FDG PET/CT scans who were divided into three groups based on the metabolic scores of LOs: low, intermediate, and high metabolism groups.

Comparative Analysis & Findings

  • LOs metabolic scores emerged as an independent prognostic factor, with patients having high metabolic activity in LOs having significantly shorter progression-free survival (PFS) and overall survival (OS) compared to those with lower activity.
  • The combination of LOs metabolism and extra-LOs tumor burden can further stratify the risk in NHL patients.
  • Metabolic activity in LOs using F-FDG is a vital prognostic indicator and may predict early treatment response in NHL patients.

Implications and Future Directions

  • The incorporation of LOs metabolic assessment into clinical practice could enable more accurate prognosis and tailored treatment strategies.
  • Future studies could explore the use of F-FDG PET/CT imaging in monitoring treatment response and identifying patients who may require additional therapeutic interventions.
  • The results of this study may also have implications for the development of new biomarkers for NHL diagnosis and monitoring.
Read Full Article