Turkish journal of haematology : official journal of Turkish Society of Haematology · 2026
Role of 18F-FDG PET/CT Metabolic Parameters in Treatment Response Evaluation and Prognostic Assessment of Hodgkin Lymphoma: A Retrospective Analysis.
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Uysal Hatice, Gültekin Aziz, Güler Nil, Şen Türk Nilay, Şimşek Fikri Selçuk, Şengöz Tarık, Yüksel Doğangün
Аннотация
OBJECTIVE: This study aimed to evaluate the predictive value of volumetric metabolic parameters and their longitudinal changes from 18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) for progression-free survival (PFS) and overall survival (OS) in Hodgkin lymphoma (HL).
MATERIALS AND METHODS: Metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were calculated from the baseline, interim, and post-treatment PET/CT scans of 63 adult patients with HL. Delta (Δ) parameters representing percentage changes were computed. Cox regression and Kaplan-Meier analyses were performed. Receiver operating characteristic curve analysis was applied to determine optimal cut-offs for baseline parameters; median dichotomization was used for delta metrics.
RESULTS: Pre-treatment MTV1 was significantly higher in patients with progression (650.98±751.34 vs. 354.15±306.72 cm3, p=0.048) and non-survivors (916.91±1040.12 vs. 369.44±310.39 cm3, p=0.024). Interim and post-treatment parameters showed similar associations (p≤0.02 for all). Cox regression confirmed MTV1 and TLG1 as significant predictors for both PFS and OS (p≤0.027). Notably, long-interval metabolic changes (ΔMTV1-3, ΔTLG1-3, ΔSUVmax1-3) demonstrated strong prognostic significance (p≤0.007 for all), with ΔSUVmax1-3 independently predicting PFS (hazard ratio: 0.30, 95% confidence interval: 0.12-0.76; p=0.011). Optimal baseline MTV1 cut-offs were 232 cm3 for PFS and 308 cm3 for OS.
CONCLUSION: Baseline volumetric parameters and long-interval metabolic changes are powerful prognostic markers in HL. ΔSUVmax1-3 provides additional risk stratification beyond baseline measurements, supporting the integration of dynamic PET metrics into clinical practice.
MATERIALS AND METHODS: Metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were calculated from the baseline, interim, and post-treatment PET/CT scans of 63 adult patients with HL. Delta (Δ) parameters representing percentage changes were computed. Cox regression and Kaplan-Meier analyses were performed. Receiver operating characteristic curve analysis was applied to determine optimal cut-offs for baseline parameters; median dichotomization was used for delta metrics.
RESULTS: Pre-treatment MTV1 was significantly higher in patients with progression (650.98±751.34 vs. 354.15±306.72 cm3, p=0.048) and non-survivors (916.91±1040.12 vs. 369.44±310.39 cm3, p=0.024). Interim and post-treatment parameters showed similar associations (p≤0.02 for all). Cox regression confirmed MTV1 and TLG1 as significant predictors for both PFS and OS (p≤0.027). Notably, long-interval metabolic changes (ΔMTV1-3, ΔTLG1-3, ΔSUVmax1-3) demonstrated strong prognostic significance (p≤0.007 for all), with ΔSUVmax1-3 independently predicting PFS (hazard ratio: 0.30, 95% confidence interval: 0.12-0.76; p=0.011). Optimal baseline MTV1 cut-offs were 232 cm3 for PFS and 308 cm3 for OS.
CONCLUSION: Baseline volumetric parameters and long-interval metabolic changes are powerful prognostic markers in HL. ΔSUVmax1-3 provides additional risk stratification beyond baseline measurements, supporting the integration of dynamic PET metrics into clinical practice.