Maximum standard uptake value of ¹⁸F-fluorodeoxyglucose positron emission tomography is a prognostic factor for progression-free survival of newly diagnosed patients with diffuse large B cell lymphoma

The treatment of patients with diffuse large B cell lymphoma (DLBCL) would be greatly facilitated with a rapid method for determining prognosis that can be performed more easily and earlier than cytological or specific pathological examinations. It has been suggested that newly diagnosed patients with DLBCL who have low maximum standard uptake value (SUV_max) on ¹⁸F-fluorodeoxyglucose positron emission tomography (FDG-PET) are more likely to be successfully treated and remain in remission compared with patients with high SUV_max, but this concept has been poorly studied. We retrospectively analyzed 50 patients with de novo DLBCL to evaluate the relationship between the SUV_max and disease progression. For patients with low SUV_max (n = 10) and high SUV_max (n = 40) (P = 0.255), respectively, the 3-year overall survival rates were 90 and 72 %, and the progression-free survival (PFS) rates were 90 and 39 % (P = 0.012). By multivariate analysis, the revised International Prognostics Index (R-IPI) and SUV_max at diagnosis were shown to predict longer PFS. The 3-year PFS for patients with low SUV_max classified into the good prognosis group by R-IPI was 100 vs. 62 % for those with high SUV_max (P = 0.161), and patients with low SUV_max classified into the poor prognosis group by R-IPI was 80 vs. 18 % for those with high SUV_max (P = 0.050). We conclude that the SUV_max on FDG-PET for newly diagnosed patients with DLBCL is an important predictor of disease progression, especially for patients with poor prognosis by R-IPI.