The prognostic value of the tumor metabolic volume in predicting the response to therapy in patients with diffuse large B-cell lymphoma

A. A. Vovchenko; Вовченко А. А.; A. B. Galitsyna; Галицына А. Б.; N. A. Falaleevа; Фалалеева Н. А.; M. M. Khodzhibekova; Ходжибекова М. М.; V. A. Shuvaev; Шуваев В. А.; D. A. Manaenkov; Манаенков Д. А.; S. A. Ivanov; Иванов С. А.

doi:10.17650/2782-3202-2024-4-4-119-128

The prognostic value of the tumor metabolic volume in predicting the response to therapy in patients with diffuse large B-cell lymphoma

Authors: Vovchenko A.A.¹^,2, Galitsyna A.B.¹^,2, Falaleevа N.A.¹^,2, Khodzhibekova M.M.³, Shuvaev V.A.¹^,2, Manaenkov D.A.¹, Ivanov S.A.¹^,2
Affiliations:
1. A.F. Tsyba Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Health of Russia
2. Obninsk Institute of Atomic Energy – branch of the National Research Nuclear University “MEPhI”
3. P.A. Hertsen Moscow Oncology Research Institute – branch of the National Medical Research Radiological Centre, Ministry of Health of Russia
Issue: Vol 4, No 4 (2024)
Pages: 119-128
Section: DIAGNOSTIC CAPABILITIES
Published: 16.01.2025
URL: https://mdonco.abvpress.ru/jour/article/view/166
DOI: https://doi.org/10.17650/2782-3202-2024-4-4-119-128
ID: 166

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Abstract

Background. Metabolic tumor volume (MTV) is an insufficiently studied parameter of positron emission tomography, combined with computer tomography (PET/CT), which has been gaining increasing interest in modern oncology in recent years. It is important to use MTV as a prognostic marker in diffuse large B-cell lymphoma (DLBCL).

Aim. To analyze the results of therapy in patients with DLBCL and to identify their relationship with MTV, determined by PET/CT data before the start of treatment, after 2 and 6 courses of therapy.

Materials and methods. The prospective study included 80 patients with a morphologically verified diagnosis of DLBCL who were treated at the A.F. Tsyba Medical Radiological Research Center from 2021 to 2024. All patients underwent therapy using R-CHOP regimens (66.25 %) and R-CHOP-like regimens (33.75 %). Each of the patients underwent 3 PET/CT studies with MTV registration – at the staging stage, after 2 and after 6 treatment courses. The median follow-up was 19.5 (4.97–45.53) months. The survival rate was calculated using the Kaplan–Mayer technique, the MTV threshold values were calculated using ROC analysis taking into account the Yuden index.

Results. On the initial PET/CT, the threshold value of MTV was 37.12 cm3 (p = 0.006). In patients with a value above the threshold, failures of classical first-line therapy were statistically significantly more common. The threshold value of MTV in PET/CT after 2 courses of treatment was 19.15 cm3 (p = 0.032), in PET/CT after 6 courses – 8.73 cm3 (p = 0.028). In patients with an MTV value above the threshold, according to the results of PET/CT performed after the 2nd and 6th courses, cases of disease progression were also statistically significantly more frequent.

Conclusion. MTV is a new prognostic factor in modern oncological practice and should be evaluated in all patients with DLBCL and taken into account when making decisions regarding therapy tactics.

Keywords

diffuse large B-cell lymphoma, metabolic tumor volume, positron emission tomography, combined with computer tomography

About the authors

A. A. Vovchenko

A.F. Tsyba Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Health of Russia; Obninsk Institute of Atomic Energy – branch of the National Research Nuclear University “MEPhI”

Author for correspondence.
Email: dr.vovchenkoartem@gmail.com
ORCID iD: 0009-0009-6911-3322

Artem Andreevich Vovchenko

4 Koroleva St., Obninsk, 249031

1 Studgorodok Territory, Obninsk, 249039

Russian Federation