Mucosa associated lymphoid tissue (MALT) lymphoma is an indolent lymphoma with good prognosis and variable 18F-FDG-avidity. Many possible prognostic factors have been investigated with controversial results, but possible prognostic role of 18F-FDG-PET/CT remains unclear. Our aim was to evaluate the prognostic impact of qualitative and semiquantitative baseline PET/CT parameters on outcome of MALT lymphoma. We retrospectively enrolled 161 patients with histologically-confirmed MALT lymphoma who underwent 18F-FDG-PET/CT before any treatment. PET images were qualitatively and semi-quantitatively analyzed by measuring the maximum standardized uptake value body weight (SUVbw), lean body mass (SUVlbm), body surface area (SUVbsa), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The Kaplan-Meier method was used to estimate the progression-free survival (PFS) and overall survival (OS) times. Cox regression models were performed to determinate the relation between PET/CT features and OS and PFS. Ninety-eight patients had positive 18F-FDG-PET/CT showing 18F-FDG uptake (mean SUVbw 10.1; SUVlbm 7.2; SUVbsa 2.7; MTV 88.8; TLG 526); the remaining 63 were not 18F-FDG avid. 18F-FDG avidity was significantly correlated with tumor size and Ki-67 score. Relapse/progression of disease occurred in 47 patients with an average time of 40.2 months; death occurred in 12 patients with an average of 59 months. At a median follow-up of 62 months, median PFS and OS were 52 and 62 months. Advanced tumor stage and extragastric site were demonstrated to be independent prognostic factors for PFS, while only tumor stage for OS. Instead PET/CT parameters were not related to survival, despite positive correlation at univariate analysis between MTV and TLG with PFS and positive PET/CT with PFS and OS. In conclusion, a 61% rate of PET avidity in biopsy-confirmed MALT lymphoma was found and it was correlated with tumor size and Ki-67 score. Only tumor stage and localization were independently correlated with PFS and OS.
Prognostic role of baseline 18F-FDG PET/CT parameters in MALT lymphoma
Albano D;Bosio G;Camoni L;Farina M;Giubbini R;Bertagna F
2018-01-01
Abstract
Mucosa associated lymphoid tissue (MALT) lymphoma is an indolent lymphoma with good prognosis and variable 18F-FDG-avidity. Many possible prognostic factors have been investigated with controversial results, but possible prognostic role of 18F-FDG-PET/CT remains unclear. Our aim was to evaluate the prognostic impact of qualitative and semiquantitative baseline PET/CT parameters on outcome of MALT lymphoma. We retrospectively enrolled 161 patients with histologically-confirmed MALT lymphoma who underwent 18F-FDG-PET/CT before any treatment. PET images were qualitatively and semi-quantitatively analyzed by measuring the maximum standardized uptake value body weight (SUVbw), lean body mass (SUVlbm), body surface area (SUVbsa), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). The Kaplan-Meier method was used to estimate the progression-free survival (PFS) and overall survival (OS) times. Cox regression models were performed to determinate the relation between PET/CT features and OS and PFS. Ninety-eight patients had positive 18F-FDG-PET/CT showing 18F-FDG uptake (mean SUVbw 10.1; SUVlbm 7.2; SUVbsa 2.7; MTV 88.8; TLG 526); the remaining 63 were not 18F-FDG avid. 18F-FDG avidity was significantly correlated with tumor size and Ki-67 score. Relapse/progression of disease occurred in 47 patients with an average time of 40.2 months; death occurred in 12 patients with an average of 59 months. At a median follow-up of 62 months, median PFS and OS were 52 and 62 months. Advanced tumor stage and extragastric site were demonstrated to be independent prognostic factors for PFS, while only tumor stage for OS. Instead PET/CT parameters were not related to survival, despite positive correlation at univariate analysis between MTV and TLG with PFS and positive PET/CT with PFS and OS. In conclusion, a 61% rate of PET avidity in biopsy-confirmed MALT lymphoma was found and it was correlated with tumor size and Ki-67 score. Only tumor stage and localization were independently correlated with PFS and OS.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
