AUTHOR=So Heejune , Lee Hyunjong , Hyun Seung Hyup , Cho Young Seok , Moon Seung Hwan , Choi Joon Young , Lee Kyung-Han 

TITLE=Metabolic bulk volume from FDG PET as an independent predictor of progression-free survival in follicular lymphoma

JOURNAL=Frontiers in Oncology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2023.1283582

DOI=10.3389/fonc.2023.1283582

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>Total metabolic tumor volume (TMTV) in <sup>18</sup>F-fluorodeoxyglucose (FDG) positron emission tomography (PET) predicts patient outcome in follicular lymphoma (FL); however, it requires laborious segmentation of all lesions. We investigated the prognostic value of the metabolic bulk volume (MBV) obtained from the single largest lesion.</p></sec><sec><title>Methods</title><p>Pretreatment FDG PET/computed tomography (CT) scans of 201 patients were analyzed for TMTV and MBV using a 41% maximum standardized uptake value (SUVmax) threshold.</p></sec><sec><title>Results</title><p>During a median follow-up of 3.2 years, 54 events, including 14 deaths, occurred. Optimal cut-offs were 121.1 cm<sup>3</sup> for TMTV and 24.8 cm<sup>3</sup> for MBV. Univariable predictors of progression-free survival (PFS) included a high Follicular Lymphoma International Prognostic Index 2 (FLIPI2) score, TMTV, and MBV. In the multivariable analysis, high TMTV and MBV were independent predictors of worse PFS (<italic>P</italic> =0.015 and 0.033). Furthermore, in a sub-group with FLIP2 scores of 0–2 (<italic>n</italic> = 132), high MBV could identify patients with worse PFS (<italic>P</italic> = 0.007). </p></sec><sec><title>Conclusion</title><p>Readily measurable MBV is useful for stratifying risk in FL patients.</p></sec>