Baseline metabolic tumor volume, total lesion g, and optimal cut-off points obtained with different segmentation methods greatly varied in patients with diffuse large B-cell lymphoma (DLBCL), according to a new study published in the journal Nuclear Medicine Communications. They also had low prognostic impact.

On the contrary, interim PET/CT parameters, especially the semiquantitative ‘Deauville-like’ parameters, gave more accurate prognostic information.

Read more about the prognosis of DLBCL

PET/CT is widely used to manage DLBCL, the researchers noted.

Here, a team of researchers, led by Tamás Györke, MD, PhD, from the Department of Nuclear Medicine, Medical Imaging Centre, Semmelweis University, in Budapest, Hungary, explored the prognostic ability of different PET biomarkers.

The investigators analyzed the metabolic tumor volume and total lesion glycolysis at baseline in 107 patients with DLBCL using 3 different segmentation methods.

They found that metabolic tumor volume and total lesion glycolysis calculations correlated well when 3 different methods were used, including glob4, 41pc, and grad. However, the optimal cut-off points obtained using the 3 methods differed markedly.

Progression-free survival was significantly different between patients divided into high and low-risk groups based on their baseline metabolic tumor volume, body weight-adjusted metabolic tumor volume, total lesion glycolysis, and body weight-adjusted total lesion glycolysis. 

It also differed significantly between the 2 groups of patients based on interim parameters. 

The researchers identified ratio PET as an independent predictor of progression-free survival. 

Combined analysis showed that patients who were positive for the proportional decrease of lesion maximal standardized uptake value with a high metabolic tumor volume had particularly low progression-free survival.

DLBCL is the most common type of lymphoma characterized by rapidly growing mass or enlarged lymph nodes in nodal or extranodal areas. Survival varies greatly among patients who have recently been diagnosed with the disease.


Czibor S, Carr R, Redondo F, et al. Prognostic parameters on baseline and interim [18F]FDG-PET/computed tomography in diffuse large B-cell lymphoma patients. Nucl Med Commun. Published online January 30, 2023. doi:10.1097/MNM.0000000000001664