Prognostic value of metabolic parameters of baseline PET/CT in patients with double expression types of diffuse large B-cell lymphoma

Abstract

Abstract Objectives To explore the value of baseline PET/CT parameters for predicting prognosis in patients with double expression lymphoma (DEL). Methods We retrospectively analyzed the clinical and [18F]FDG PET/CT imaging data of 118 patients diagnosed with DLBCL by pathological examination at two independent medical centers from October 2015 to September 2022. We used receiver operating characteristic (ROC) curve analysis to determine the optimal threshold for the maximum standardized uptake value (SUVmax), the total metabolic tumor volume (TMTV), and the total lesion glycolysis (TLG) in predicting overall survival (OS) rate. Kaplan-Meier survival analysis, univariate and multivariate analyses were performed to predict OS rate, construct a survival prediction model, plot a calibration curve for the model, a time-dependent area under the ROC curve (tdAUC), and a decision curve analysis (DCA) curve, and calculate the C-index of the model. Results The area under the curve (AUC) of the ROC curve for TMTV was 0.705, with corresponding cutoff values of 230.9 cm3. In multivariate analysis, Eastern Cooperative Oncology Group performance status (ECOG PS) (HR=3.989, P=0.002) and TMTV (HR=4.042, P<0.008) were identified as independent predictors of OS. A combined model of ECOG PS and TMTV was found to be superior to IPI in predicting OS. Conclusions TMTV, a metabolic index, and ECOG PS, a clinical risk factor, are independent predictors of OS in patients with DEL, and their combination can provide more accurate prognostic predictions.