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Article

High Basal Maximal Standardized Uptake Value (SUVmax) in Follicular Lymphoma Identifies Patients with a Low Risk of Long-Term Relapse

1
Hematology, Department of Translational and Precision Medicine, Sapienza University of Rome, Via Benevento 6, 00161 Rome, Italy
2
Nuclear Medicine, Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy
3
Nuclear Medicine, Istituto Neurologico Mediterraneo IRCCS Neuromed, 86077 Pozzilli, Italy
*
Author to whom correspondence should be addressed.
Academic Editors: Daruka Mahadevan and Alberto Zamò
Cancers 2021, 13(12), 2876; https://doi.org/10.3390/cancers13122876
Received: 17 March 2021 / Revised: 3 June 2021 / Accepted: 7 June 2021 / Published: 9 June 2021
(This article belongs to the Section Cancer Causes, Screening and Diagnosis)
A simple and easily available parameter, such as SUVmax, could represent a useful tool in clinical practice to evaluate at diagnosis the risk of late relapse in Follicular Lymphoma. A higher basal FDG uptake (>6) was associated with a lower long-term relapse probability only in the absence of other risk factors (bone marrow involvement, B-symptoms, extra-nodal disease, elevated LDH, and/or b2-microglobulin), which can overwhelm the favourable effects of a high SUV. A low basal SUVmax reflects an indolent behaviour with a higher rate of late relapse, thus, requiring a prolonged follow-up.
Background: Despite that the unfavorable prognostic role of a high Total Metabolic Tumor Volume (TMTV) in Follicular Lymphoma has been demonstrated, the role of SUVmax alone at baseline PET/CT could have a different prognostic role. Patients and Methods: We performed a retrospective observational monocentric cohort study. All patients affected by FL who underwent a basal PET/CT were included. Two subgroups were identified and compared in terms of PFS and OS: (A) Basal SUVmax ≤ 6; and (B) Basal SUVmax > 6. Results: Ninety-four patients were included, 34 in group A (36.2%) and 60 in group B (63.8%). The PFS at two years was comparable in the two groups (97%). The five-year PFS was 73.5% for group A and 95% for group B (p 0.005). The five-year PFS in the whole cohort was 87.5%. A clear advantage was confirmed in group A in the absence of other risk factors. Patients with SUVmax ≤ 6 and no risk factors showed a 5-year PFS of 73% against 83% for patients with SUVmax > 6 and at least two risk factors. Conclusion: A high FDG uptake favorably correlated with PFS. A low basal SUVmax reflected a higher rate of late relapse requiring a prolonged follow-up. The basal SUVmax is an approachable parameter with prognostic implications. View Full-Text
Keywords: follicular lymphoma; PET-SCAN; lymphoproliferative disease; lymphoma; SUV follicular lymphoma; PET-SCAN; lymphoproliferative disease; lymphoma; SUV
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MDPI and ACS Style

Assanto, G.M.; Ciotti, G.; Brescini, M.; De Luca, M.L.; Annechini, G.; D’Elia, G.M.; Agrippino, R.; Del Giudice, I.; Martelli, M.; Chiaravalloti, A.; Pulsoni, A. High Basal Maximal Standardized Uptake Value (SUVmax) in Follicular Lymphoma Identifies Patients with a Low Risk of Long-Term Relapse. Cancers 2021, 13, 2876. https://doi.org/10.3390/cancers13122876

AMA Style

Assanto GM, Ciotti G, Brescini M, De Luca ML, Annechini G, D’Elia GM, Agrippino R, Del Giudice I, Martelli M, Chiaravalloti A, Pulsoni A. High Basal Maximal Standardized Uptake Value (SUVmax) in Follicular Lymphoma Identifies Patients with a Low Risk of Long-Term Relapse. Cancers. 2021; 13(12):2876. https://doi.org/10.3390/cancers13122876

Chicago/Turabian Style

Assanto, Giovanni M., Giulia Ciotti, Mattia Brescini, Maria L. De Luca, Giorgia Annechini, Gianna M. D’Elia, Roberta Agrippino, Ilaria Del Giudice, Maurizio Martelli, Agostino Chiaravalloti, and Alessandro Pulsoni. 2021. "High Basal Maximal Standardized Uptake Value (SUVmax) in Follicular Lymphoma Identifies Patients with a Low Risk of Long-Term Relapse" Cancers 13, no. 12: 2876. https://doi.org/10.3390/cancers13122876

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