18-Fluoro-deoxyglucose positron emission tomography report interpretation as predictor of outcome in diffuse large B-cell lymphoma including analysis of 'indeterminate' reports

Alexandra Thomas, Roger D. Gingrich, Brian J. Smith, Laura Jacobus, Kay Ristow, Cristine Allmer, Matthew J. Maurer, Thomas Matthew Habermann, Brian K. Link

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

This study evaluates the predictive value of post-therapy 18-fluoro-deoxyglucose positron emission tomography (FDG-PET), including indeterminate studies, following curative-intent therapy in diffuse large B-cell lymphoma (DLBCL). Consecutive patients from September 2002 to December 2005 were prospectively offered enrollment in an observational registry. Available FDG-PET reports after primary therapy were interpreted by hematologistoncologists as positive, negative, or indeterminate. One hundred twenty-five patients with DLBCL had a median follow-up of 35.2 months. Ninety-three percent were treated with R-CHOP-like therapy. Twenty percent of PET reports were judged indeterminate. Event-free survival (EFS) at 3 years for the negative and indeterminate groups was 85 and 71, respectively (p0.28 by log-rank). Overall survival (OS) at 3 years for negative, indeterminate, and positive groups was 89, 88, and 48. Combining the pre-therapy International Prognostic Index (IPI) with the post-therapy FDG-PET result added to the predictive value of the study for patients. Three-year EFS for patients with low or low-intermediate IPI risk and an indeterminate FDG-PET report was 93, while for those with high or high-intermediate pre-therapy IPI the 3-year EFS was 45 (p<0.02). Interpreting FDG-PET reports following curative-intent chemotherapy in patients is informative but imprecise, and incorporation of pre-therapy prognosis can improve predictive utility.

Original languageEnglish (US)
Pages (from-to)439-446
Number of pages8
JournalLeukemia and Lymphoma
Volume51
Issue number3
DOIs
StatePublished - 2010

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Keywords

  • Diffuse large B-cell lymphoma
  • FDG-PET
  • Prognosis

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research
  • Medicine(all)

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