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.