Titre :

Tumor Location Relative to the Spleen Is a Prognostic Factor in Lymphoma Patients: A Demonstration from the REMARC Trial.

Auteur(s) :

Girum, Kibrom B. [Auteur]
AP-HP. Université Paris Saclay
Cottereau, Anne-Ségolène [Auteur]
Université Paris Descartes - Paris 5 [UPD5]
Vercellino, Laetitia [Auteur]
Rebaud, Louis [Auteur]
AP-HP. Université Paris Saclay
Clerc, Jérôme [Auteur]
Université Paris Descartes - Paris 5 [UPD5]
Casasnovas, Olivier [Auteur]
Morschhauser, Franck [Auteur]
Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365
Thieblemont, Catherine [Auteur]
Buvat, Irene [Auteur]

Titre de la revue :

Journal of Nuclear Medicine

Nom court de la revue :

J Nucl Med

Numéro :

65

Pagination :

313-319

Date de publication :

2024-02

ISSN :

1535-5667

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Baseline [18F]FDG PET/CT radiomic features can improve the survival prediction in patients with diffuse large B-cell lymphoma (DLBCL). The purpose of this study was to investigate whether characterizing tumor locations ...
Lire la suite >Baseline [18F]FDG PET/CT radiomic features can improve the survival prediction in patients with diffuse large B-cell lymphoma (DLBCL). The purpose of this study was to investigate whether characterizing tumor locations relative to the spleen location in baseline [18F]FDG PET/CT images predicts survival in patients with DLBCL and improves the predictive value of total metabolic tumor volume (TMTV) and age-adjusted international prognostic index (IPI). Methods: This retrospective study included 301 DLBCL patients from the REMARC (NCT01122472) cohort. Physicians delineated the tumor regions, whereas the spleen was automatically segmented using an open-access artificial intelligence algorithm. We systematically measured the distance between the centroid of the spleen and all other lesions, defining the SD of these distances as the lesion spread (SpreadSpleen). We calculated the maximum distance between the spleen and another lesion (Dspleen) for each patient and normalized it with the body surface area, resulting in standardized Dspleen (sDspleen). The predictive value of each PET/CT feature for progression-free survival (PFS) and overall survival (OS) was evaluated through univariate and multivariate time-dependent Cox models and Kaplan–Meier analysis. Results: In total, 282 patients (mean age, 68.33 ± 5.41 y; 164 men) were evaluated. The artificial intelligence algorithm successfully segmented the spleen in 96% of the patients. SpreadSpleen, Dspleen, and sDspleen were correlated neither with TMTV (Pearson ρ < 0.23) nor with IPI (Pearson ρ < 0.15). When median values were used as the cutoff, SpreadSpleen, Dspleen, and sDspleen all significantly classified patients into 2 risk groups for PFS and OS (P < 0.001). They complemented TMTV and IPI to classify the patients into 3 risk groups for PFS and OS (P < 0.001). Integrating SpreadSpleen, Dspleen, or sDspleen into a Cox model on the basis of TMTV, IPI, and TMTV combined with IPI significantly improved the concordance index for PFS and OS (P < 0.05). Conclusion: Baseline PET/CT features that characterize tumor spread and dissemination relative to the spleen strongly predicted survival in patients with DLBCL. Integrating these features with TMTV and IPI further improved survival prediction. Whole-body [18F]FDG PET/CT is a standard of care for staging and assessing responses of patients with diffuse large B-cell lymphoma (DLBCL). The CT images are often preferred to view the anatomic structures, and the [18F]FDG PET images are used to capture the molecular activities of the tumor. Despite the widespread use of the age-adjusted international prognostic index (IPI) in DLBCL, recent literature suggests that image-based biomarkers could also be used for this purpose (1). Baseline [18F]FDG PET–based features that characterize the tumor burden, such as the total metabolic tumor volume (TMTV), have been shown to predict survival in DLBCL patients (1–4). Recently introduced tumor dissemination features, such as the distance between the 2 farthest lesions (Dmax) and the maximum distance between the largest lesion and another lesion (Dbulk), have shown promising results for predicting survival (5–9). Their simplicity, intuitive interpretation, and value in predicting the outcome inspired this study. Given that the spleen plays a particular role in the lymphatic system and particularly in DLBCL (10), we assumed that the spleen could serve as a reference organ to model the disease distribution and dissemination over the whole body. The purpose of this study was to investigate whether tumor distribution and dissemination measured relative to the spleen from baseline [18F]FDG PET/CT images had prognostic values independent of that of TMTV and IPI and improved survival prediction in DLBCL patients. The individual prognostic values of these new image-based features were evaluated in terms of progression-free survival (PFS) and overall survival (OS). We also assessed the added prognostic value of these biomarkers when they are combined with TMTV and age-adjusted IPI.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

Université de Lille
CHU Lille

Collections :

• Groupe de Recherche sur les formes Injectables et les Technologies Associées (GRITA) - ULR 7365

Date de dépôt :

2024-01-03T01:17:01Z
2024-06-10T13:56:26Z