Enhancing prognostic accuracy in PMBCL: semiquantitative analysis of interim PET/CT scans.
Abstract
Primary mediastinal large B-cell lymphoma (PMBCL) is a rare, aggressive lymphoma affecting young adults. Interim PET/CT (iPET/CT) scans are used to assess treatment response, but the positive predictive value of standard Deauville score remains limited. This retrospective multicenter study analyzed 116 PMBCL patients treated with anthracycline-based chemoimmunotherapy, focusing on 90 patients with high quality iPET/CT. Semiquantitative radiomics metrics, including changes in maximum standardized uptake value (dSUVmax), metabolic tumor volume (dMTV), and total lesion glycolysis (dTLG), were assessed alongside event-free survival (EFS). All interim and final PET/CT scans were independently reviewed by two nuclear medicine physicians blinded to outcomes. Among the 90 patients, 62 (68.9%) were iPET-positive (Deauville scores 4-5). Event-free survival (EFS) at 3 years was significantly higher in iPET-negative patients compared to iPET-positive patients (75% vs. 29%; p < 0.01). Radiomics analysis demonstrated that dSUVmax, dMTV, and dTLG provided superior predictive accuracy for EFS. Values below optimized cut-off thresholds demonstrated significantly better outcomes (e.g., 3-y EFS: 77.8% for dSUVmax ≥ 80% vs. 11.1% for dSUVmax < 80%, p < 0.01). Radiomics-based metrics outperformed visual iPET/CT assessment in identifying high-risk patients, underscoring their potential in guiding treatment. Future research should integrate radiomics with clinical factors to enhance PET-guided treatment strategies.
Description
Keywords
Event-free survival, Interim PET, PET/CT, Primary mediastinal large b-cell lymphoma, Quantitative metrics, Radiomics
Funding
AZV NU21-03-00411, Palacký University Open Science Fund
Related Items
Research Projects
Organizational Units
Journal Issue
Collections
Type
Journal Article
Multicenter Study
Multicenter Study
License
© 2025. The Author(s).
Attribution 4.0 International
Attribution 4.0 International
Date
2025-10-07
Publisher
Springer Nature
Book
Journal
Scientific reports
Scientific Reports
Scientific Reports
item.page.journal.issn
item.page.volume.title
DOI
10.1038/s41598-025-18649-9