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Tumour necrosis as assessed with 18F-FDG PET is a potential prognostic marker in diffuse large B cell lymphoma independent of MYC rearrangements.


ABSTRACT:

Objectives

MYC gene rearrangements in diffuse large B cell lymphomas (DLBCLs) result in high proliferation rates and are associated with a poor prognosis. Strong proliferation is associated with high metabolic demand and tumour necrosis. The aim of this study was to investigate differences in the presence of necrosis and semiquantitative 18F-FDG PET metrics between DLBCL cases with or without a MYC rearrangement. The prognostic impact of necrosis and semiquantitative 18F-FDG PET parameters was investigated in an explorative survival analysis.

Methods

Fluorescence in situ hybridisation analysis for MYC rearrangements, visual assesment, semiquantitative analysis of 18F-FDG PET scans and patient survival analysis were performed in 61 DLBCL patients, treated at a single referral hospital between 2008 and 2015.

Results

Of 61 tumours, 21 (34%) had a MYC rearrangement (MYC+). MYC status was neither associated with the presence of necrosis on 18F-FDG PET scans (necrosisPET; p?=?1.0) nor associated with the investigated semiquantitative parameters maximum standard uptake value (SUVmax; p?=?0.43), single highest SUVmax (p?=?0.49), metabolic active tumour volume (MATV; p?=?0.68) or total lesion glycolysis (TLG; p?=?0.62). A multivariate patient survival analysis of the entire cohort showed necrosisPET as an independent prognostic marker for disease-specific survival (DSS) (HR?=?13.9; 95% CI 3.0-65; p?=?0.001).

Conclusions

MYC rearrangements in DLBCL have no influence on the visual parameter necrosisPET or the semi-quantiative parameters SUVmax, MATV and TLG. Irrespective of MYC rearrangements, necrosisPET is an independent, adverse prognostic factor for DSS.

Key points

• Retrospective analysis indicates that MYC rearrangement is not associated with necrosis on 18 F-FDG PET (necrosis PET ) scans or semiquantitative 18 F-FDG PET parameters. • Necrosis PET is a potential independent adverse prognostic factor for disease-specific survival in patients with DLBCL and is not influenced by the presence of MYC rearrangements.

SUBMITTER: Kahle XU 

PROVIDER: S-EPMC6795618 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Publications

Tumour necrosis as assessed with <sup>18</sup>F-FDG PET is a potential prognostic marker in diffuse large B cell lymphoma independent of MYC rearrangements.

Kahle Xaver U XU   Hovingh Menno M   Noordzij Walter W   Seitz Annika A   Diepstra Arjan A   Visser Lydia L   van den Berg Anke A   van Meerten Tom T   Huls Gerwin G   Boellaard Ronald R   Kwee Thomas C TC   Nijland Marcel M  

European radiology 20190426 11


<h4>Objectives</h4>MYC gene rearrangements in diffuse large B cell lymphomas (DLBCLs) result in high proliferation rates and are associated with a poor prognosis. Strong proliferation is associated with high metabolic demand and tumour necrosis. The aim of this study was to investigate differences in the presence of necrosis and semiquantitative <sup>18</sup>F-FDG PET metrics between DLBCL cases with or without a MYC rearrangement. The prognostic impact of necrosis and semiquantitative <sup>18</  ...[more]

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