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Ligero M, Simó M, Carpio C, Iacoboni G, Balaguer‐Montero M, Navarro V, Sánchez‐Salinas MA, Bobillo S, Marín‐Niebla A, Iraola‐Truchuelo J, Abrisqueta P, Sala‐Llonch R, Bosch F, Perez‐Lopez R, Barba P. PET-based radiomics signature can predict durable responses to CAR T-cell therapy in patients with large B-cell lymphoma. EJHaem 2023; 4:1081-1088. [PMID: 38024636 PMCID: PMC10660117 DOI: 10.1002/jha2.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/05/2023] [Accepted: 07/14/2023] [Indexed: 12/01/2023]
Abstract
Chimeric antigen receptor (CAR) T-cell therapy is a promising treatment option for relapsed or refractory (R/R) large B-cell lymphoma (LBCL). However, only a subset of patients will present long-term benefit. In this study, we explored the potential of PET-based radiomics to predict treatment outcomes with the aim of improving patient selection for CAR T-cell therapy. We conducted a single-center study including 93 consecutive R/R LBCL patients who received a CAR T-cell infusion from 2018 to 2021, split in training set (73 patients) and test set (20 patients). Radiomics features were extracted from baseline PET scans and clinical benefit was defined based on median progression-free survival (PFS). Cox regression models including the radiomics signature, conventional PET biomarkers and clinical variables were performed for most relevant outcomes. A radiomics signature including 4 PET-based parameters achieved an AUC = 0.73 for predicting clinical benefit in the test set, outperforming the predictive value of conventional PET biomarkers (total metabolic tumor volume [TMTV]: AUC = 0.66 and maximum standardized uptake value [SUVmax]: AUC = 0.59). A high radiomics score was also associated with longer PFS and OS in the multivariable analysis. In conclusion, the PET-based radiomics signature predicted efficacy of CAR T-cell therapy and outperformed conventional PET biomarkers in our cohort of LBCL patients.
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Affiliation(s)
- Marta Ligero
- Radiomics GroupVall d'Hebron Institute of Oncology (VHIO)Vall d'Hebron Barcelona Hospital Campus (VHUH)BarcelonaSpain
| | - Marc Simó
- Nuclear Medicine DepartmentVall d'Hebron University Hospital, Autonomous University of BarcelonaBarcelonaSpain
| | - Cecilia Carpio
- Department of HematologyExperimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University HospitalBarcelonaBarcelonaSpain
| | - Gloria Iacoboni
- Department of HematologyExperimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University HospitalBarcelonaBarcelonaSpain
| | - Maria Balaguer‐Montero
- Radiomics GroupVall d'Hebron Institute of Oncology (VHIO)Vall d'Hebron Barcelona Hospital Campus (VHUH)BarcelonaSpain
| | - Victor Navarro
- Oncology Data Science (ODysSey) GroupVall d'Hebron Institute of Oncology (VHIO)BarcelonaSpain
| | - Mario Andres Sánchez‐Salinas
- Department of HematologyExperimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University HospitalBarcelonaBarcelonaSpain
| | - Sabela Bobillo
- Department of HematologyExperimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University HospitalBarcelonaBarcelonaSpain
| | - Ana Marín‐Niebla
- Department of HematologyExperimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University HospitalBarcelonaBarcelonaSpain
| | - Josu Iraola‐Truchuelo
- Department of HematologyExperimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University HospitalBarcelonaBarcelonaSpain
| | - Pau Abrisqueta
- Department of HematologyExperimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University HospitalBarcelonaBarcelonaSpain
| | - Roser Sala‐Llonch
- Faculty of MedicineDepartment of BiomedicineInstitute of Neurosciences, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)University of BarcelonaBarcelonaSpain
- Centro de Investigación Biomédica en Red de BioingenieríaBiomateriales y Nanomedicina (CIBER‐BBN)BarcelonaSpain
| | - Francesc Bosch
- Department of HematologyExperimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University HospitalBarcelonaBarcelonaSpain
| | - Raquel Perez‐Lopez
- Radiomics GroupVall d'Hebron Institute of Oncology (VHIO)Vall d'Hebron Barcelona Hospital Campus (VHUH)BarcelonaSpain
| | - Pere Barba
- Department of HematologyExperimental Hematology, Vall d’Hebron Institute of Oncology (VHIO), Vall d’Hebron University HospitalBarcelonaBarcelonaSpain
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Yang J, Yan J, Li J, Yang Z, Zhang H, Zhao Q, Xu W. El papel de los parámetros metabólicos de la 18F-FDG PET/TC en el linfoma linfoblástico pediátrico. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2020.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Reed JD, Masenge A, Buchner A, Omar F, Reynders D, Vorster M, Van de Wiele C, Sathekge M. The Utility of Metabolic Parameters on Baseline F-18 FDG PET/CT in Predicting Treatment Response and Survival in Paediatric and Adolescent Hodgkin Lymphoma. J Clin Med 2021; 10:jcm10245979. [PMID: 34945274 PMCID: PMC8706037 DOI: 10.3390/jcm10245979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
Lymphoma is the third most common paediatric cancer. Early detection of high-risk patients is necessary to anticipate those who require intensive therapy and follow-up. Current literature shows that residual tumor avidity on PET (Positron Emission Tomography) following chemotherapy corresponds with decreased survival. However, the value of metabolic parameters has not been adequately investigated. In this retrospective study, we aimed to evaluate the prognostic value of metabolic and other parameters in paediatric and adolescent Hodgkin lymphoma. We recorded tMTV (total Metabolic Tumor Volume), TLG (Total Lesion Glycolysis), and SUVmax (maximum Standard Uptake Value) on baseline PET, as well the presence of bone marrow or visceral involvement. HIV (human immunodeficiency virus) status and baseline biochemistry from clinical records were noted. All patients received stage-specific standard of care therapy. Response assessment on end-of-treatment PET was evaluated according to the Deauville criteria. We found that bone marrow involvement (p = 0.028), effusion (p < 0.001), and treatment response (p < 0.001) on baseline PET, as well as HIV status (p = 0.036) and baseline haemoglobin (p = 0.039), were significantly related to progression-free survival (PFS), whereas only effusion (p = 0.017) and treatment response (p = 0.050) were predictive of overall survival (OS). Only baseline tMTV predicted treatment response (p = 0.017). This confirms the value of F-18 FDG PET/CT (Fluoro-deoxy-glucose Positron Emission Tomography/Computed Tomography) in prognostication in paediatric and adolescent Hodgkin lymphoma; however, further studies are required to define the significance of metabolic parameters.
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Affiliation(s)
- Janet Denise Reed
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0002, South Africa;
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Correspondence: (J.D.R.); (C.V.d.W.); (M.S.); Tel.: +012-354-2273 & +012-354-1794 (M.S.)
| | - Andries Masenge
- Department of Statistics, University of Pretoria, Pretoria 0002, South Africa;
| | - Ane Buchner
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Department of Paediatric Oncology, University of Pretoria, Pretoria 0002, South Africa
| | - Fareed Omar
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Department of Paediatric Oncology, University of Pretoria, Pretoria 0002, South Africa
| | - David Reynders
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Department of Paediatric Oncology, University of Pretoria, Pretoria 0002, South Africa
| | - Mariza Vorster
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0002, South Africa;
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
| | - Christophe Van de Wiele
- Department of Radiology and Nuclear Medicine, University of Ghent, 9000 Ghent, Belgium
- Correspondence: (J.D.R.); (C.V.d.W.); (M.S.); Tel.: +012-354-2273 & +012-354-1794 (M.S.)
| | - Mike Sathekge
- Department of Nuclear Medicine, University of Pretoria, Pretoria 0002, South Africa;
- Steve Biko Academic Hospital, Pretoria 0002, South Africa; (A.B.); (F.O.); (D.R.)
- Correspondence: (J.D.R.); (C.V.d.W.); (M.S.); Tel.: +012-354-2273 & +012-354-1794 (M.S.)
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Xiao Z, Mo Y, Long W, Li R, Li X, Wei Y, Fan W, Zhang X. Value of baseline and end of chemotherapy 18F-FDG PET/CT in pediatric patients with Burkitt lymphoma. Leuk Lymphoma 2021; 62:2873-2881. [PMID: 34165390 DOI: 10.1080/10428194.2021.1941933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was to analyze whether the baseline metabolic parameters of 18F-FDG PET/CT in pediatric patients with Burkitt lymphoma (BL) can predict treatment response and prognosis. We retrospectively analyzed 68 pediatric patients with BL who underwent PET/CT before treatment. PET images were analyzed semi-quantitatively by measuring the maximum standardized uptake (SUVmax), total metabolic tumor volume (tMTV), and total lesion glycolysis (TLG). Survival curves were plotted according to the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards regression models were used to assess the relation between potential variables and outcomes. tMTV and TLG were significantly lower in patients with complete response compared with those with partial response at the end of treatment. PET metabolic parameters (tMTV and TLG) were the independent prognostic values for outcome. TMTV and TLG were significantly connected with treatment response and prognosis in pediatric with BL.
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Affiliation(s)
- Zizheng Xiao
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yiwen Mo
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Wen Long
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ruping Li
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xinling Li
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Yuan Wei
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Wei Fan
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Xu Zhang
- Department of Nuclear Medicine, Sun Yat-sen University Cancer Canter, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
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Yang J, Yan J, Li J, Yang Z, Zhang H, Zhao Q, Xu W. The role of 18F-FDG PET/CT metabolic parameters in pediatric lymphoblastic lymphoma. Rev Esp Med Nucl Imagen Mol 2021. [DOI: 10.1016/j.remnie.2020.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/04/2020] [Indexed: 01/02/2023]
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Rodríguez Taroco MG, Cuña EG, Pages C, Schelotto M, González-Sprinberg GA, Castillo LA, Alonso O. Prognostic value of imaging markers from 18FDG-PET/CT in paediatric patients with Hodgkin lymphoma. Nucl Med Commun 2021; 42:306-14. [PMID: 33306628 DOI: 10.1097/MNM.0000000000001337] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Identification of imaging prognostic parameters for early therapy personalisation to reduce treatment-related morbidity in paediatric Hodgkin lymphoma (HL). Our aim was to evaluate quantitative markers from baseline 2-[18F]fluoro-2-deoxy-d-glucose PET/CT as prognostic factors for treatment outcomes. Another goal was assessing the prognostic value of Deauville score at interim PET/CT. METHODS Twenty-one patients were prospectively enrolled. Median age was 12 years (range 6-17); 13 were female. Patients underwent PET/CT for disease staging (bPET), at the end of two cycles of chemotherapy (iPET) and after chemotherapy. A total of 173 lesions were segmented from bPET. We calculated 51 texture features for each lesion. Total metabolic tumour volume and total lesion glycolysis from bPET were calculated for response prediction at iPET. Univariate and multivariate analyses were used for optimal cut-off values to separate responders at iPET according to the Deauville score. RESULTS We identified four texture features as possible independent predictors of treatment outcomes at iPET. The areas under the ROC for univariate analysis were 0.89 (95% CI, 0.75-1), 0.82 (95% CI, 0.64-1), 0.79 (95% CI, 0.59-0.99) and 0.89 (95% CI, 0.75-1). The survival curves for patients assigned Deauville scores 1, 2, 3 and X were different from those assigned a score 4, with 4-year progression free-survival (PFS) rates of 85 versus 29%, respectively (P = 0.05). CONCLUSIONS We found four textural features as candidates for predicting early response to chemotherapy in paediatric patients with HL. The Deauville score at iPET was useful for differentiating PFS rates.
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