The impact of bone marrow involvement on prognosis in diffuse large B-cell lymphoma : an 18F-FDG PET/CT volumetric segmentation study

Doma, Andrej (author), Studen, Andrej (author), Jezeršek Novaković, Barbara (author)

Background: This study assessed the prognostic value of tumor burden in bone marrow (BM) and total disease (TD), as depicted on 18F-FDG PET/CT in 140 DLBCL patients, for complete remission after first-line systemic treatment (iCR) and 3- and 5-year overall survival (OS3 and OS5). Methods: Baseline 18F-FDG PET/CT scans of 140 DLBCL patients were segmented to quantify metabolic tumor volume (MTV), total lesion glycolysis (TLG), and SUVmax in BMI, findings elsewhere (XL), and TD. Results: Bone marrow involvement (BMI) presented in 35 (25%) patients. Median follow-up time was 47 months; 79 patients (56%) achieved iCR. iCR was significantly associated with TD MTV, XL MTV, BM PET positivity, and International Prognostic Index (IPI). OS3 was significantly worse with TD MTV, XL MTV, IPI, and age. OS5 was significantly associated with IPI, but not with MTVs and TLGs. Univariate factors predicting OS3 were XL MTV (hazard ratio [HR] = 1.29), BMI SUVmax (HR = 0.56), and IPI (HR = 1.92). By multivariate analysis, higher IPI (HR = 2.26) and BMI SUVmax (HR = 0.91) were significant independent predictors for OS3. BMI SUVmax resulted in a negative coefficient and hence indicated a protective effect. Conclusions: Baseline 18F-FDG PET/CT MTV is significantly associated with survival. BMI identified on 18F-FDG PET/CT allows appropriate treatment that may improve survival.

• Language: English
• Keywords: bone marrow, diffuse large B-cell lymphoma, survival, 18F-FDG, PET/CT, MTV
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine; FMF - Faculty of Mathematics and Physics
• Publication status: Published
• Publication version: Version of Record
• Year: 2024
• Number of pages: 17 str.
• Numbering: Vol. 16, iss. 22, art. 3762
• PID: 20.500.12556/RUL-176040
• UDC: 616.4
• ISSN on article: 2072-6694
• DOI: 10.3390/cancers16223762
• COBISS.SI-ID: 214486531
• Publication date in RUL: 19.11.2025

Record is a part of a journal

• Title: Cancers
• Shortened title: Cancers
• Publisher: MDPI
• ISSN: 2072-6694
• COBISS.SI-ID: 517914137

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: kostni mozeg, difuzni velikocelični limfom B, preživetje

Projects

• Funder: ARRS - Slovenian Research Agency
• Project number: P3-0321
• Name: Napovedni dejavniki poteka bolezni in odgovora na zdravljenje pri različnih vrstah raka

• Funder: ARRS - Slovenian Research Agency
• Project number: P1-0389
• Name: Medicinska fizika