PET/TC en endocrinología nuclear. Resultados de la encuesta difundida por las distintas redes sociales de la SEMNIM en España / PET/CT in nuclear endocrinology: Results of the survey diffused through different social networks of the SEMNIM in Spain

Objetivo Desde el Grupo de Trabajo de Endocrinología de la SEMNIM, se planteó la necesidad de conocer el uso actual de la tecnología PET/TC aplicada en el campo de la endocrinología. El objetivo de la encuesta era obtener una fotografía instantánea del uso de la PET/TC en endocrinología nuclear, con el fin de conocer si está siendo adecuadamente utilizada y detectar posibles necesidades. Material y métodos Durante el primer trimestre del 2022, se analizaron los datos obtenidos de una encuesta que se difundió a través de distintas redes sociales a lo largo de la segunda mitad del 2021. Se recogieron datos sobre el uso de las distintas técnicas PET/TC en el carcinoma diferenciado de tiroides, el carcinoma medular de tiroides, los tumores neuroendocrinos y el hiperparatiroidismo. Resultados Un total de 15 centros respondieron la encuesta. El 79% de los hospitales utilizan la 18F-FDG PET/TC en el diagnóstico y/o seguimiento del carcinoma diferenciado de tiroides (media de exploraciones anuales: 36,9; rango 10-100). El 85% utilizan la 18F-DOPA PET/TC para el estudio de recidiva bioquímica de carcinoma medular de tiroides (media estudios anuales: 7,8; rango 2-20). El 77% utilizan la 18F-DOPA PET/TC para el estudio de los tumores neuroendocrinos: el 77% utilizan la 18F-DOPA PET/TC (media de 10 exploraciones anuales; rango 2-30) y el 69% utilizan el 68Ga-DOTA-SA (media de 24,7 exploraciones anuales; rango 2-127). El 79% utilizan la 18F-colina PET/TC para el estudio del hiperparatiroidismo (media de 30,1 exploraciones anuales; rango 10-120). Conclusiones El uso de la técnica PET/TC en endocrinología aún no está generalizado, sin embargo, vimos que las indicaciones en las cuales se utiliza son, en general, las reportadas en los distintos consensos (AU)

Aim To know the current use of the PET/CT technology applied in the field of endocrinology, the Endocrinology Working Group of SEMNIM proposed conducting a survey. The objective was to obtain a snapshot of the use of PET/CT in nuclear endocrinology, to know if it is being used properly and detect possible needs. Material and methods During the first quarter of 2022, we analyzed the data obtained from a survey that was distributed through different social networks throughout the second half of 2021. The survey asked for the use of the different PET/CT techniques available in Spain in different endocrinological pathologies like differentiated thyroid carcinoma, medullary thyroid carcinoma, neuroendocrine tumors and hyperparathyroidism. Results A total of 15 centers responded to the survey. A percentage of 79 of hospitals used 18F-FDG PET/CT in the diagnosis and/or follow-up of differentiated thyroid carcinoma (mean annual studies: 36.9; range 10–100); 85% used 18F-DOPA PET/CT for the study of biochemical recurrence of medullary thyroid carcinoma (mean annual studies: 7.8; range 2–20); 77% used 18F-DOPA PET/CT for the study of neuroendocrine tumors: 77% used 18F-DOPA PET/CT (mean of 10 scans per year; range 2–30) and 69% used 68Ga-DOTA-SA (mean of 24.7 studies per year; range 2–127); 79% used 18F-choline PET/CT for the study of hyperparathyroidism (mean of 30.1 annual studies; range 10–120). Conclusions We detected that the use of the PET/CT technique in endocrinology is not yet widespread, however, we saw that the indications in which it is used are, in general, those reported in the different consensus (AU)

Nuestra experiencia en el manejo diagnóstico-terapéutico a corto plazo del paciente con displasia anal / Our experience in the short-term diagnostic-therapeutic management of the patient with anal dysplasia

Introducción: La neoplasia intraepitelial anal (NIA) es una lesión premaligna del carcinoma escamoso anal. Los varones VIH que tienen sexo con varones, es la población de riesgo más afectada. La citología y anuscopia son los métodos mejor aceptados para su diagnóstico, aunque es controvertido qué pacientes deben completarlo con una biopsia. Tampoco está bien establecido qué pacientes deben someterse a tratamiento y cuál es el mejor. Con este estudio, queremos exponer nuestra experiencia en el manejo diagnóstico-terapéutico de la NIA a corto plazo. Métodos: Estudio observacional retrospectivo de pacientes con riesgo de NIA con una citología anal alterada a los que se les realizó una anuscopia de alta resolución con biopsia. Tras la confirmación histológica de displasia iniciaron tratamiento con ácido tricloroacético. Se comprobó su efectividad con una citología posterior. Se analizaron las variables demográficas de la muestra y los resultados de las pruebas diagnósticas y de tratamiento. Resultados: La mayoría eran varones VIH positivos (104/115) y el 50% mantenían relaciones sexuales con otros varones. Se incluyeron 115 pacientes con citología anal alterada, de los cuales el 92% presentaron displasia en la biopsia. El 97% con atipia de significado incierto en la citología presentaron displasia histológicamente. El 60% de los pacientes normalizó la citología tras el tratamiento. Conclusión: Se debe considerar de forma sistemática la detección precoz de la NIA en poblaciones de riesgo conocidas. Cualquier anormalidad citológica debe ser biopsiada. El ácido tricloroacético puede ser un tratamiento efectivo consiguiendo un alto porcentaje de regresión, aunque actualmente la información con la que contamos es de bajo nivel de evidencia. (AU)

Introduction: Anal intraepithelial neoplasia (AIN) is a premalignant lesion of anal squamous cell carcinoma. HIV-positive males who have sex with males, are the most affected at-risk population. Cytology and anuscopy are the best accepted methods for its diagnosis, although it is controversial which patients should complete it with a biopsy. Neither which patients should undergo treatment nor which is the best treatment is not well established. With this study, we would like to present our experience in the diagnostic-therapeutic management of AIN in the short term. Methods: Retrospective observational study of patients at risk of AIN with altered anal cytology who underwent high-resolution anuscopy with biopsy. After histological confirmation of dysplasia, they started treatment with trichloroacetic acid. Its effectiveness was verified by subsequent cytology. The demographic variables of the sample and the results of both diagnostic and treatment tests were analyzed. Results: The majority were HIV-positive males (104/115) and 50% had sexual relations with other men. We included 115 patients with altered anal cytology, of whom 92% had dysplasia on biopsy. 97% with atypia of uncertain significance on cytology had histological dysplasia. Cytology normalized after treatment in 60% of patients. Conclusion: Early detection of AIN should be routinely considered in known at-risk populations. Any cytological abnormality should be biopsied. Tricholoroacetic acid can be an effective treatment achieving a high percentage of regression, although currently, the information we have is of low level of evidence. (AU)

PET/CT in nuclear endocrinology: Results of the survey diffused through different social networks of the SEMNIM in Spain.

AIM: To know the current use of the PET/CT technology applied in the field of endocrinology, the Endocrinology Working Group of SEMNIM proposed conducting a survey. The objective was to obtain a snapshot of the use of PET/CT in nuclear endocrinology, to know if it is being used properly and detect possible needs. MATERIAL AND METHODS: During the first quarter of 2022, we analyzed the data obtained from a survey that was distributed through different social networks throughout the second half of 2021. The survey asked for the use of the different PET/CT techniques available in Spain in different endocrinological pathologies like differentiated thyroid carcinoma, medullary thyroid carcinoma, neuroendocrine tumors and hyperparathyroidism. RESULTS: A total of 15 centers responded to the survey. A percentage of 79 of hospitals used 18F-FDG PET/CT in the diagnosis and/or follow-up of differentiated thyroid carcinoma (mean annual studies: 36.9; range 10-100); 85% used 18F-DOPA PET/CT for the study of biochemical recurrence of medullary thyroid carcinoma (mean annual studies: 7.8; range 2-20); 77% used 18F-DOPA PET/CT for the study of neuroendocrine tumors: 77% used 18F-DOPA PET/CT (mean of 10 scans per year; range 2-30) and 69% used 68Ga-DOTA-SA (mean of 24.7 studies per year; range 2-127); 79% used 18F-choline PET/CT for the study of hyperparathyroidism (mean of 30.1 annual studies; range 10-120). CONCLUSIONS: We detected that the use of the PET/CT technique in endocrinology is not yet widespread, however, we saw that the indications in which it is used are, in general, those reported in the different consensus.

Our experience in the short-term diagnostic-therapeutic management of the patient with anal dysplasia.

INTRODUCTION: Anal intraepithelial neoplasia (AIN) is a premalignant lesion of anal squamous cell carcinoma. HIV-positive males who have sex with males, are the most affected at-risk population. Cytology and anuscopy are the best accepted methods for its diagnosis, although it is controversial which patients should complete it with a biopsy. Neither which patients should undergo treatment nor which is the best treatment is not well established. With this study, we would like to present our experience in the diagnostic-therapeutic management of AIN in the short term. METHODS: Retrospective observational study of patients at risk of AIN with altered anal cytology who underwent high-resolution anuscopy with biopsy. After histological confirmation of dysplasia, they started treatment with trichloroacetic acid. Its effectiveness was verified by subsequent cytology. The demographic variables of the sample and the results of both diagnostic and treatment tests were analyzed. RESULTS: The majority were HIV-positive males (104/115) and 50% had sexual relations with other men. We included 115 patients with altered anal cytology, of whom 92% had dysplasia on biopsy. 97% with atypia of uncertain significance on cytology had histological dysplasia. Cytology normalized after treatment in 60% of patients. CONCLUSION: Early detection of AIN should be routinely considered in known at-risk populations. Any cytological abnormality should be biopsied. Tricholoroacetic acid can be an effective treatment achieving a high percentage of regression, although currently, the information we have is of low level of evidence.

Evaluación del valor pronóstico de los parámetros volumétricos metabólicos calculados con la 18F-FDG PET/TC y su valor añadido a las características moleculares en pacientes con linfoma B difuso de células grandes / Evaluation of the prognostic value of the metabolic volumetric parameters calculated with 18F-FDG PET/CT and its value added to the molecular characteristics in patients with diffuse large b-cell lymphoma

Introducción y objetivos: El volumen metabólico tumoral (VMT) y la glicólisis total de la lesión (TLG) son predictores pronósticos en los pacientes con linfoma B difuso de células grandes (LBDCG). El objetivo del presente estudio es evaluar el impacto pronóstico de los parámetros volumétricos basales calculados con la tomografía por emisión de positrones/tomografía computarizada con 18F-fluorodesoxiglucosa (18F-FDG PET/TC) y su valor agregado a las características moleculares en pacientes con LBDCG tipo no especificado (NOS). Metodología: Se trata de un estudio retrospectivo observacional, en el que se incluyeron 35 pacientes sometidos a un 18F-FDG PET/TC basal previo al tratamiento. Se realizó un análisis univariable de los parámetros volumétricos (VMT y TLG), estudio inmunohistoquímico y traslocaciones cromosómicas. El método para el cálculo de los parámetros volumétricos fue el umbral SUV 2,5. La comparación entre los modelos predictivos se seleccionó en función del valor de criterio de información de Akaike (AIC), bayesiano (BIC) y C de Harrell, después de realizar un modelo de regresión de riesgos proporcionales de Cox. Además, se realizó un análisis univariable de los parámetros volumétricos, según los datos del estudio inmunohistoquímico utilizando la prueba de Wilcoxon-Mann-Whitney. Resultados: Al realizar un análisis univariable se evidenció que el VMT y la TLG son predictores de la supervivencia libre de progresión (SLP) y de la supervivencia global (SG), con una alta capacidad de discriminación. El añadir el VMT y la TLG al estudio inmunohistoquímico y a la traslocación cromosómica proporcionó un mejor valor pronóstico a la SLP y SG en los pacientes diagnosticados con LBDCG tipo NOS. Así mismo, se evidenció que los valores de los parámetros volumétricos eran menores en los pacientes que presentaron un fenotipo células B centro germinal (GCB) frente a los pacientes con fenotipo células B activadas (ABC) que presentaron valores mayores (AU)

Introduction and objectives: Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are prognostic predictors in patients with diffuse large B-cell lymphoma (DLBCL). The objective of this study is to evaluate the prognostic impact of the baseline volumetric parameters calculated with positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT) and its added value to the molecular characteristics in patients with DLBCL not otherwise specified (NOS). Methodology: This is a retrospective observational study, which included 35 patients who underwent a baseline 18F-FDG PET/CT prior to treatment. A univariate analysis of the volumetric parameters (MTV and TLG), immunohistochemical study and chromosomal translocations were performed. The method for calculating the volumetric parameters was the SUV 2.5 threshold. The comparison between the predictive models was selected based on the information criterion value of Akaike (AIC), bayesian (BIC) and Harrell's C, after performing a Cox proportional hazards regression model. In addition, a univariate analysis of the volumetric parameters was performed according to the data of the immunohistochemical study using the Wilcoxon-Mann-Whitney test. Results: A univariate analysis revealed that VMT and TLG are predictors of progression-free survival (PFS) and overall survival (OS), with a high discrimination capacity. Adding VMT and TLG to the immunohistochemical study and chromosomal translocation provided a better prognostic value for PFS and OS in patients diagnosed with DLBCL-NOS. Likewise, it was evidenced that the values of the volumetric parameters were lower in patients who presented a germinal center B cell phenotype (GCB) compared to patients with an activated B cell phenotype (ABC) who presented higher values. Conclusion: MTV and TLG added to the immunohistochemical study and chromosomal translocation provided a better prognostic value for PFS and OS (AU)

Evaluation of the prognostic value of the metabolic volumetric parameters calculated with 18F-FDG PET/CT and its value added to the molecular characteristics in patients with diffuse large B-cell lymphoma.

INTRODUCTION AND OBJECTIVES: Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are prognostic predictors in patients with diffuse large B-cell lymphoma (DLBCL). The objective of this study is to evaluate the prognostic impact of the baseline volumetric parameters calculated with positron emission tomography/computed tomography with 18F-fluorodeoxyglucose (18F-FDG PET/CT) and its added value to the molecular characteristics in patients with DLBCL not otherwise specified (NOS). METHODOLOGY: This is a retrospective observational study, which included 35 patients who underwent a baseline 18F-FDG PET/CT prior to treatment. A univariate analysis of the volumetric parameters (MTV and TLG), immunohistochemical study and chromosomal translocations were performed. The method for calculating the volumetric parameters was the SUV 2.5 threshold. The comparison between the predictive models was selected based on the information criterion value of Akaike (AIC), bayesian (BIC) and Harrell's C, after performing a Cox proportional hazards regression model. In addition, a univariate analysis of the volumetric parameters was performed according to the data of the immunohistochemical study using the Wilcoxon-Mann-Whitney test. RESULTS: A univariate analysis revealed that VMT and TLG are predictors of progression-free survival (PFS) and overall survival (OS), with a high discrimination capacity. Adding VMT and TLG to the immunohistochemical study and chromosomal translocation provided a better prognostic value for PFS and OS in patients diagnosed with DLBCL-NOS. Likewise, it was evidenced that the values of the volumetric parameters were lower in patients who presented a germinal center B cell phenotype (GCB) compared to patients with an activated B cell phenotype (ABC) who presented higher values. CONCLUSION: MTV and TLG added to the immunohistochemical study and chromosomal translocation provided a better prognostic value for PFS and OS in patients diagnosed with DLBCL-NOS.

Multidisciplinary practice guidelines for the diagnosis, genetic counseling and treatment of pheochromocytomas and paragangliomas

'Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that arise from chromaffin cells of the adrenal medulla and the sympathetic/parasympathetic neural ganglia, respectively. The heterogeneity in its etiology makes PPGL diagnosis and treatment very complex. The aim of this article was to provide practical clinical guidelines for the diagnosis and treatment of PPGLs from a multidisciplinary perspective, with the involvement of the Spanish Societies of Endocrinology and Nutrition (SEEN), Medical Oncology (SEOM), Medical Radiology (SERAM), Nuclear Medicine and Molecular Imaging (SEMNIM), Otorhinolaryngology (SEORL), Pathology (SEAP), Radiation Oncology (SEOR), Surgery (AEC) and the Spanish National Cancer Research Center (CNIO). We will review the following topics: epidemiology; anatomy, pathology and molecular pathways; clinical presentation; hereditary predisposition syndromes and genetic counseling and testing; diagnostic procedures, including biochemical testing and imaging studies; treatment including catecholamine blockade, surgery, radiotherapy and radiometabolic therapy, systemic therapy, local ablative therapy and supportive care. Finally, we will provide follow-up recommendations (AU)

Multidisciplinary practice guidelines for the diagnosis, genetic counseling and treatment of pheochromocytomas and paragangliomas.

Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors that arise from chromaffin cells of the adrenal medulla and the sympathetic/parasympathetic neural ganglia, respectively. The heterogeneity in its etiology makes PPGL diagnosis and treatment very complex. The aim of this article was to provide practical clinical guidelines for the diagnosis and treatment of PPGLs from a multidisciplinary perspective, with the involvement of the Spanish Societies of Endocrinology and Nutrition (SEEN), Medical Oncology (SEOM), Medical Radiology (SERAM), Nuclear Medicine and Molecular Imaging (SEMNIM), Otorhinolaryngology (SEORL), Pathology (SEAP), Radiation Oncology (SEOR), Surgery (AEC) and the Spanish National Cancer Research Center (CNIO). We will review the following topics: epidemiology; anatomy, pathology and molecular pathways; clinical presentation; hereditary predisposition syndromes and genetic counseling and testing; diagnostic procedures, including biochemical testing and imaging studies; treatment including catecholamine blockade, surgery, radiotherapy and radiometabolic therapy, systemic therapy, local ablative therapy and supportive care. Finally, we will provide follow-up recommendations.

The utility HBA1c test as a screening biomarker for detecting gestational diabetes mellitus.

BACKGROUND: Glycated Hb (HbA1c) has not been used for the diagnosis of gestational diabetes mellitus (GDM). Measurement of HbA1c levels is less complicated and more comfortable than glucose challenge test (GCT) for pregnant women. We studied HbA1c as a biomarker of GDM and as a screening test to avoid the use of GCT. METHODS: A prospective case-control study involves 745 pregnant women between 24th and 28th gestation week. HbA1c levels were measured and GDM was diagnosed according to Carpenter-Coustan criteria. Mean and SD were calculated for GCT value, HbA1c, age, and body mass index (BMI). A receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic performance of HbA1c test in diagnosing GDM. Cut-off points were calculated to rule out GDM and sensitivity (Se) and specificity (Sp) were also determined. A study of the implementation of HbA1c cut-offs was performed to avoid the GCT or to perform the confirmatory oral glucose tolerance test (OGTT). RESULTS: The area under the curve (AUC) was 0.67 (0.58-0.76). Using 4.6% HbA1c as a cut-off prevented false negatives but only decreased the number of GCTs performed by 7.2%. However, using 4.7% HbA1c resulted in one false negative (reduction of 15.0%). Finally, by selecting 4.8% HbA1c, we found two false negatives, but there were 25.9% who do not require a GCT. CONCLUSIONS: Adoption of HbA1c as a screening test for GDM may eliminate the need of GCT. Although the HbA1c test does not have sufficient Se and Sp to be used as the only diagnostic test, the use of a rule-out strategy in combination with the OGTT could be useful.

Evaluación del valor pronóstico de los diferentes métodos de cálculo del volumen metabólico tumoral con 18F-FDG PET/TC, en pacientes con linfoma B difuso de células grandes / Evaluation of the prognostic value of different methods of calculating the tumour metabolic volume with 18F-FDG PET/CT, in patients with diffuse large cell B-cell lymphoma

INTRODUCCIÓN Y OBJETIVOS: El volumen metabólico tumoral (VMT) es un indicador de pronóstico prometedor en el linfoma B difuso de células grandes (LBDCG). El objetivo del presente estudio es evaluar los diferentes métodos para el cálculo del VMT basal con la tomografía por emisión de positrones/tomografía computarizada con 18F-fluorodesoxiglucosa (18F-FDG PET/TC) en pacientes con LBDCG, relacionando cada uno de los volúmenes medidos con la supervivencia libre de progresión (SLP) y la supervivencia global (SG). METODOLOGÍA: Se trata de un estudio de cohortes retrospectivo analítico, en el que se incluyeron 34 pacientes sometidos a un 18F-FDG PET/TC basal previo al tratamiento. Comparamos tres umbrales SUV 2,5, SUV 40% del SUV máximo y SUV medio hepático (PERCIST), para el cálculo de los biomarcadores VMT y glucólisis total de la lesión (TLG) relacionándolos con la SLP y SG. El mejor modelo predictivo se seleccionó en función del valor de criterio de información de Akaike (AIC) después de realizar una regresión de riesgos proporcionales de Cox. RESULTADOS: Con relación a la SLP, muestran diferencias estadísticamente significativas: VMT 2,5, TLG 2,5, VMT 40%, TLG 40%, VMT y TLG calculados con el umbral PERCIST. Entre estos, el que tiene un AIC menor es VMT 2,5, por lo que se considera el mejor parámetro para predecir la SLP. Con respecto a la SG, muestra diferencias estadísticamente significativas: VMT 2,5, VMT y TLG calculados con el umbral PERCIST. Entre estos tres, el que tiene un AIC menor es VMT 2,5, por lo que se considera el mejor parámetro para predecir la SG. Además, un mayor valor de VMT y TLG, se asocia a peor SLP y SG. CONCLUSIÓN: El VMT calculado con el umbral SUV 2,5 parece ser el mejor parámetro para predecir la SLP y SG en los pacientes diagnosticados con LBDCG con el 18F-FDG PET/TC

INTRODUCTION AND OBJECTIVES: Metabolic tumor volume (MTV) is a promising indicator of prognosis in diffuse large B-cell lymphoma (DLBCL). The aim of the present study is to evaluate the different methods for the calculation of the basal metabolic tumor volume with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the patients with DLBCL, relating each one of the volumes measured with progression-free survival (PFS) and overall survival (OS). METHODOLOGY: This is a retrospective analytical cohort study, in which 34 patients underwent to 18F-FDG PET/CT baseline prior to treatment. We compared three SUV thresholds 2.5, SUV 40% of the maximum SUV and SUV mean hepatic uptake (PERCIST) for the calculation of MTV and total lesion glycolysis (TLG) biomarkers, relating them to the PFS and OS. The best predictive model was selected based on the Akaike's information criterion (AIC) after performing a Cox proportional hazards regression. RESULTS: In relation to the PFS, they show statistically significant differences: MTV 2.5, TLG 2.5, MTV 40, TLG 40, MTV and TLG calculated with the PERCIST threshold. Among these, the one that has a lower AIC is MTV 2.5, so it is considered the best parameter to predict the PFS. With respect to OS, it shows statistically significant differences: MTV 2.5, VMT and TLG calculated with the PERCIST threshold. Among these three, the one with the lowest AIC is MTV 2.5, which is why it is considered the best parameter to predict OS. In addition, a higher value of MTV and total tumor glycolysis (TLG), is associated with worse PFS and OS. CONCLUSION: The MTV calculated with the threshold SUV 2.5 seems to be the best parameter to predict PFS and OS in patients diagnosed with DLBCL with 18F-FDG PET/CT

Evaluation of the prognostic value of different methods of calculating the tumour metabolic volume with 18F-FDG PET/CT, in patients with diffuse large cell B-cell lymphoma. / Evaluación del valor pronóstico de los diferentes métodos de cálculo del volumen metabólico tumoral con 18F-FDG PET/TC, en pacientes con linfoma B difuso de células grandes.

INTRODUCTION AND OBJECTIVES: Metabolic tumor volume (MTV) is a promising indicator of prognosis in diffuse large B-cell lymphoma (DLBCL). The aim of the present study is to evaluate the different methods for the calculation of the basal metabolic tumor volume with 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in the patients with DLBCL, relating each one of the volumes measured with progression-free survival (PFS) and overall survival (OS). METHODOLOGY: This is a retrospective analytical cohort study, in which 34 patients underwent to 18F-FDG PET/CT baseline prior to treatment. We compared three SUV thresholds 2.5, SUV 40% of the maximum SUV and SUV mean hepatic uptake (PERCIST) for the calculation of MTV and total lesion glycolysis (TLG) biomarkers, relating them to the PFS and OS. The best predictive model was selected based on the Akaike's information criterion (AIC) after performing a Cox proportional hazards regression. RESULTS: In relation to the PFS, they show statistically significant differences: MTV 2.5, TLG 2.5, MTV 40, TLG 40, MTV and TLG calculated with the PERCIST threshold. Among these, the one that has a lower AIC is MTV 2.5, so it is considered the best parameter to predict the PFS. With respect to OS, it shows statistically significant differences: MTV 2.5, VMT and TLG calculated with the PERCIST threshold. Among these three, the one with the lowest AIC is MTV 2.5, which is why it is considered the best parameter to predict OS. In addition, a higher value of MTV and total tumor glycolysis (TLG), is associated with worse PFS and OS CONCLUSION: The MTV calculated with the threshold SUV 2.5 seems to be the best parameter to predict PFS and OS in patients diagnosed with DLBCL with 18F-FDG PET/CT.

La Revista Española de Medicina Nuclear e Imagen Molecular en 2020 / Revista Española de Medicina Nuclear e Imagen Molecular in 2020

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