Prognostic superiority of International Prognostic Index over [18F]FDG PET/CT volumetric parameters in post-transplant lymphoproliferative disorder

F. Montes de Jesus; D. Dierickx; V. Vergote; W. Noordzij; R. A. J. O. Dierckx; C. M. Deroose; A. W. J. M. Glaudemans; O. Gheysens; T. C. Kwee

doi:10.1186/s13550-021-00769-8

EJNMMI Research (Mar 2021)

Prognostic superiority of International Prognostic Index over [18F]FDG PET/CT volumetric parameters in post-transplant lymphoproliferative disorder

F. Montes de Jesus,
D. Dierickx,
V. Vergote,
W. Noordzij,
R. A. J. O. Dierckx,
C. M. Deroose,
A. W. J. M. Glaudemans,
O. Gheysens,
T. C. Kwee

Affiliations

F. Montes de Jesus: Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen
D. Dierickx: Department of Hematology, University Hospitals Leuven
V. Vergote: Department of Hematology, University Hospitals Leuven
W. Noordzij: Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen
R. A. J. O. Dierckx: Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen
C. M. Deroose: Department of Nuclear Medicine, University Hospitals Leuven
A. W. J. M. Glaudemans: Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen
O. Gheysens: Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc
T. C. Kwee: Department of Radiology, University of Groningen, University Medical Center Groningen

DOI: https://doi.org/10.1186/s13550-021-00769-8
Journal volume & issue: Vol. 11, no. 1
pp. 1 – 8

Abstract

Read online

Abstract Background Post-transplant lymphoproliferative disorders (PTLDs) are a spectrum of hematological malignancies occurring after solid organ and hematopoietic stem cell transplantation. [18F]FDG PET/CT is routinely performed at PTLD diagnosis, allowing for both staging of the disease and quantification of volumetric parameters, such as whole-body metabolic tumor volume (MTV) and total lesion glycolysis (TLG). In this retrospective study, we aimed to determine the prognostic value of MTV and TLG in PTLD patients, together with other variables of interest, such as the International Prognostic Index (IPI), organ transplant type, EBV tumor status, time after transplant, albumin levels and PTLD morphology. Results A total of 88 patients were included. The 1-, 3-, 5- year overall survival rates were 67%, 58% and 43% respectively. Multivariable analysis indicated that a high IPI (HR: 1.56, 95% CI: 1.13–2.16) and an EBV-negative tumor (HR: 2.71, 95% CI: 1.38–5.32) were associated with poor overall survival. Patients with a kidney transplant had a longer overall survival than any other organ recipients (HR: 0.38 95% CI: 0.16–0.89). IPI was found to be the best predicting parameter of overall survival in our cohort. Whole-body MTV, TLG, time after transplant, hypoalbuminemia and PTLD morphology were not associated with overall survival. Conclusion [18F]FDG PET/CT whole-body volumetric quantitative parameters were not predictive of overall survival in PTLD. In our cohort, high IPI and an EBV-negative tumor were found to predictors of worse overall survival while kidney transplant patients had a longer overall survival compared to other organ transplant recipients

Published in EJNMMI Research

ISSN: 2191-219X (Online)
Publisher: SpringerOpen
Country of publisher: United Kingdom
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: http://www.ejnmmires.com/

About the journal

Abstract

Keywords