We assessed the predictive value of new radiomic features characterizing lesion dissemination in baseline 18F-FDG PET and tested whether combining them with baseline metabolic tumor volume (MTV) could improve prediction of progression-free survival (PFS) and overall survival (OS) in diffuse large B-cell lymphoma (DLBCL) patients. Methods: From the LNH073B trial (NCT00498043), patients with advanced-stage DLCBL and 18F-FDG PET/CT images available for review were selected. MTV and several radiomic features, including the distance between the 2 lesions that were farthest apart (Dmaxpatient), were calculated. Receiver-operating-characteristic analysis was used to determine the optimal cutoff for quantitative variables, and Kaplan-Meier survival analyses were performed. Results: With a median age of 46 y, 95 patients were enrolled, half of them treated with R-CHOP biweekly (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) and the other half with R-ACVBP (rituximab, doxorubicin, cyclophosphamide, vindesine, bleomycin, and prednisone), with no significant impact on outcome. Median MTV and Dmaxpatient were 375 cm3 and 45 cm, respectively. The median follow-up was 44 mo. High MTV and Dmaxpatient were adverse factors for PFS (P = 0.027 and P = 0.0003, respectively) and for OS (P = 0.0007 and P = 0.0095, respectively). In multivariate analysis, only Dmaxpatient was significantly associated with PFS (P = 0.0014) whereas both factors remained significant for OS (P = 0.037 and P = 0.0029, respectively). Combining MTV (>384 cm3) and Dmaxpatient (>58 cm) yielded 3 risk groups for PFS (P = 0.0003) and OS (P = 0.0011): high with 2 adverse factors (4-y PFS and OS of 50% and 53%, respectively, n = 18), low with no adverse factor (94% and 97%, n = 36), and an intermediate category with 1 adverse factor (73% and 88%, n = 41). Conclusion: Combining MTV with a parameter reflecting the tumor burden dissemination further improves DLBCL patient risk stratification at staging.

中文翻译：

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弥漫性大型B细胞淋巴瘤中的18F-FDG PET传播特征可预测结果。

我们评估了在基线18F-FDG PET中表征病变扩散的新放射学特征的预测价值，并测试了将其与基线代谢肿瘤体积（MTV）结合是否可以改善弥漫性无进展生存期（PFS）和总体生存期（OS）的预测大B细胞淋巴瘤（DLBCL）患者。方法：从LNH073B试验（NCT00498043）中，选择可回顾的晚期DLCBL和18F-FDG PET / CT图像患者。计算了MTV和几个放射学特征，包括两个相距最远的病变之间的距离（Dmax Patient）。接受者操作特征分析用于确定定量变量的最佳临界值，并进行Kaplan-Meier生存分析。结果：年龄为46岁的中位年龄为46岁，招募了95例患者，其中半数每两周一次接受R-CHOP治疗（利妥昔单抗，环磷酰胺，阿霉素，长春新碱和泼尼松），另一半接受R-ACVBP（利妥昔单抗，阿霉素，环磷酰胺，长春地辛，博来霉素和泼尼松），对预后无明显影响。MTV和Dmax Patient的中位数分别为375 cm3和45 cm。中位随访时间为44 mo。高MTV和Dmax患者是PFS（分别为P = 0.027和P = 0.0003）和OS（分别为P = 0.0007和P = 0.0095）的不利因素。在多变量分析中，只有Dmax Patient与PFS显着相关（P = 0.0014），而OS的两个因素均显着（分别为P = 0.037和P = 0.0029）。将MTV（> 384 cm3）和Dmax Patient（> 58 cm）合并会产生3个PFS（P = 0.0003）和OS（P = 0.0011）的风险组：较高，有2个不利因素（4-y PFS和OS分别为50％和53％，n = 18），较低，没有不利因素（94％和97％，n = 36），以及中级类别，其中1个不利因素系数（73％和88％，n = 41）。结论：将MTV与反映肿瘤负荷分布的参数相结合可进一步改善DLBCL患者分期的危险分层。