Value of ¹⁸F-FDG PET/CT Deauville score and ΔSUV_max in evaluating medium-term prognosis of patients with chemotherapy for diffuse large B-cell lymphoma

Objective To explore the value of 18 fluoro-fluorodeoxyglucose positron emission tomography/computer tomography (¹⁸F-FDG PET/CT) display Deauville score and change of max standardized uptake value (ΔSUV_max) in evaluating medium-term prognosis of patients with chemotherapy for diffuse large B-cell lymphoma (DLBCL).

Methods The ¹⁸F-FDG PET/CT images of 78 patients with DLBCL in the medium-term of chemotherapy were analyzed retrospectively. The receiver operating characteristic (ROC) curve was used to analyze the ΔSUV_max and ΔSUV_max%, the patients were divided into different groups according to optimal cut-off values of ΔSUV_max and ΔSUV_max% as well as Deauville score, and they were also divided into germinal center B-cell-like (GCB) type and non-GCB type. Kaplan-Meier survival curve and Cox regression analysis were performed to evaluate the ability of Deauville score and ΔSUV_max methods in prognosis.

Results A total of 78 patients were divided into progressive group with 24 cases and non-progressive group with 54 cases; the mean value of ΔSUV_max was (3.42±9.90) in the progressive group, which was significantly lower than (8.76±5.58) in the non-progressive group (P < 0.05); the median value of ΔSUV_max% in the progressive group was 34.88%, which was significantly lower than 78.16% in the non-progressive group (P < 0.01). The area under the curve (AUC) of ΔSUV_max and ΔSUV_max% was 0.667 and 0.882 respectively (P < 0.01), and taking the cut-off values of 7.95 and 67.34% respectively as the grouping criteria, the Kaplan-Meier analysis showed that there were significant differences in 2-year progression-free survival (PFS) between groups (44.4% versus 82.4%, 33.3% versus 95.6%, P < 0.01). The 2-year PFS of Deauville < 4 (PET negative) group was 91.9%, which was significantly higher than 48.8% of Deauville≥4 (PET positive) group (P < 0.01). The 2-year PFS of GCB type was 90.3%, which was significantly higher than 55.3% of non-GCB type (P < 0.01). Cox multivariate analysis showed that ΔSUV_max% and immunohistochemical typing were the independent predictors (P < 0.01).

Conclusion Both Deauville score and ΔSUV_max methods have high values in the medium-term prognostic evaluation of chemotherapy for DLBCL, and ΔSUV_max% and immunohistochemical typing were the independent predictors for PFS.