Tumour necrosis as assessed with 18 F-FDG PET is a potential prognostic marker in diffuse large B cell lymphoma independent of MYC rearrangements

Xaver U. Kahle; Menno Hovingh; Walter Noordzij; Annika Seitz; Arjan Diepstra; Lydia Visser; Anke van den Berg; Tom van Meerten; Gerwin Huls; Ronald Boellaard; Thomas C. Kwee; Marcel Nijland

doi:https://doi.org/10.1007/s00330-019-06178-9

Tumour necrosis as assessed with 18 F-FDG PET is a potential prognostic marker in diffuse large B cell lymphoma independent of MYC rearrangements

Xaver U. Kahle, Menno Hovingh, Walter Noordzij, Annika Seitz, Arjan Diepstra, Lydia Visser, Anke van den Berg, Tom van Meerten, Gerwin Huls, Ronald Boellaard, Thomas C. Kwee, Marcel Nijland

Research output: Contribution to journal › Article › Academic › peer-review

6 Citations (Scopus)

Abstract

Objectives: MYC gene rearrangements in diffuse large B cell lymphomas (DLBCLs) result in high proliferation rates and are associated with a poor prognosis. Strong proliferation is associated with high metabolic demand and tumour necrosis. The aim of this study was to investigate differences in the presence of necrosis and semiquantitative 18 F-FDG PET metrics between DLBCL cases with or without a MYC rearrangement. The prognostic impact of necrosis and semiquantitative 18 F-FDG PET parameters was investigated in an explorative survival analysis. Methods: Fluorescence in situ hybridisation analysis for MYC rearrangements, visual assesment, semiquantitative analysis of 18 F-FDG PET scans and patient survival analysis were performed in 61 DLBCL patients, treated at a single referral hospital between 2008 and 2015. Results: Of 61 tumours, 21 (34%) had a MYC rearrangement (MYC + ). MYC status was neither associated with the presence of necrosis on 18 F-FDG PET scans (necrosis PET ; p = 1.0) nor associated with the investigated semiquantitative parameters maximum standard uptake value (SUV max ; p = 0.43), single highest SUV max (p = 0.49), metabolic active tumour volume (MATV; p = 0.68) or total lesion glycolysis (TLG; p = 0.62). A multivariate patient survival analysis of the entire cohort showed necrosis PET as an independent prognostic marker for disease-specific survival (DSS) (HR = 13.9; 95% CI 3.0–65; p = 0.001). Conclusions: MYC rearrangements in DLBCL have no influence on the visual parameter necrosis PET or the semi-quantiative parameters SUV max , MATV and TLG. Irrespective of MYC rearrangements, necrosis PET is an independent, adverse prognostic factor for DSS. Key Points: • Retrospective analysis indicates that MYC rearrangement is not associated with necrosis on 18 F-FDG PET (necrosis PET ) scans or semiquantitative 18 F-FDG PET parameters. • Necrosis PET is a potential independent adverse prognostic factor for disease-specific survival in patients with DLBCL and is not influenced by the presence of MYC rearrangements.

Original language	English
Pages (from-to)	6018-6028
Number of pages	11
Journal	European Radiology
Volume	29
Issue number	11
DOIs	https://doi.org/10.1007/s00330-019-06178-9
Publication status	Published - 1 Nov 2019
Externally published	Yes

Keywords

Diffuse, large B cell, lymphoma
Fluorodeoxyglucose F18
MYC oncogene
Necrosis
Positron emission tomography

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https://doi.org/10.1007/s00330-019-06178-9

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Kahle, X. U., Hovingh, M., Noordzij, W., Seitz, A., Diepstra, A., Visser, L., van den Berg, A., van Meerten, T., Huls, G., Boellaard, R., Kwee, T. C., & Nijland, M. (2019). Tumour necrosis as assessed with 18 F-FDG PET is a potential prognostic marker in diffuse large B cell lymphoma independent of MYC rearrangements. European Radiology, 29(11), 6018-6028. https://doi.org/10.1007/s00330-019-06178-9

@article{90c4ffc8876542ba9f04c89de74d51ec,

title = "Tumour necrosis as assessed with 18 F-FDG PET is a potential prognostic marker in diffuse large B cell lymphoma independent of MYC rearrangements",

abstract = "Objectives: MYC gene rearrangements in diffuse large B cell lymphomas (DLBCLs) result in high proliferation rates and are associated with a poor prognosis. Strong proliferation is associated with high metabolic demand and tumour necrosis. The aim of this study was to investigate differences in the presence of necrosis and semiquantitative 18 F-FDG PET metrics between DLBCL cases with or without a MYC rearrangement. The prognostic impact of necrosis and semiquantitative 18 F-FDG PET parameters was investigated in an explorative survival analysis. Methods: Fluorescence in situ hybridisation analysis for MYC rearrangements, visual assesment, semiquantitative analysis of 18 F-FDG PET scans and patient survival analysis were performed in 61 DLBCL patients, treated at a single referral hospital between 2008 and 2015. Results: Of 61 tumours, 21 (34%) had a MYC rearrangement (MYC + ). MYC status was neither associated with the presence of necrosis on 18 F-FDG PET scans (necrosis PET ; p = 1.0) nor associated with the investigated semiquantitative parameters maximum standard uptake value (SUV max ; p = 0.43), single highest SUV max (p = 0.49), metabolic active tumour volume (MATV; p = 0.68) or total lesion glycolysis (TLG; p = 0.62). A multivariate patient survival analysis of the entire cohort showed necrosis PET as an independent prognostic marker for disease-specific survival (DSS) (HR = 13.9; 95% CI 3.0–65; p = 0.001). Conclusions: MYC rearrangements in DLBCL have no influence on the visual parameter necrosis PET or the semi-quantiative parameters SUV max , MATV and TLG. Irrespective of MYC rearrangements, necrosis PET is an independent, adverse prognostic factor for DSS. Key Points: • Retrospective analysis indicates that MYC rearrangement is not associated with necrosis on 18 F-FDG PET (necrosis PET ) scans or semiquantitative 18 F-FDG PET parameters. • Necrosis PET is a potential independent adverse prognostic factor for disease-specific survival in patients with DLBCL and is not influenced by the presence of MYC rearrangements.",

keywords = "Diffuse, large B cell, lymphoma, Fluorodeoxyglucose F18, MYC oncogene, Necrosis, Positron emission tomography",

author = "Kahle, {Xaver U.} and Menno Hovingh and Walter Noordzij and Annika Seitz and Arjan Diepstra and Lydia Visser and {van den Berg}, Anke and {van Meerten}, Tom and Gerwin Huls and Ronald Boellaard and Kwee, {Thomas C.} and Marcel Nijland",

year = "2019",

month = nov,

day = "1",

doi = "https://doi.org/10.1007/s00330-019-06178-9",

language = "English",

volume = "29",

pages = "6018--6028",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer Verlag",

number = "11",

}

Kahle, XU, Hovingh, M, Noordzij, W, Seitz, A, Diepstra, A, Visser, L, van den Berg, A, van Meerten, T, Huls, G, Boellaard, R, Kwee, TC & Nijland, M 2019, 'Tumour necrosis as assessed with 18 F-FDG PET is a potential prognostic marker in diffuse large B cell lymphoma independent of MYC rearrangements', European Radiology, vol. 29, no. 11, pp. 6018-6028. https://doi.org/10.1007/s00330-019-06178-9

TY - JOUR

T1 - Tumour necrosis as assessed with 18 F-FDG PET is a potential prognostic marker in diffuse large B cell lymphoma independent of MYC rearrangements

AU - Kahle, Xaver U.

AU - Hovingh, Menno

AU - Noordzij, Walter

AU - Seitz, Annika

AU - Diepstra, Arjan

AU - Visser, Lydia

AU - van den Berg, Anke

AU - van Meerten, Tom

AU - Huls, Gerwin

AU - Boellaard, Ronald

AU - Kwee, Thomas C.

AU - Nijland, Marcel

PY - 2019/11/1

Y1 - 2019/11/1

N2 - Objectives: MYC gene rearrangements in diffuse large B cell lymphomas (DLBCLs) result in high proliferation rates and are associated with a poor prognosis. Strong proliferation is associated with high metabolic demand and tumour necrosis. The aim of this study was to investigate differences in the presence of necrosis and semiquantitative 18 F-FDG PET metrics between DLBCL cases with or without a MYC rearrangement. The prognostic impact of necrosis and semiquantitative 18 F-FDG PET parameters was investigated in an explorative survival analysis. Methods: Fluorescence in situ hybridisation analysis for MYC rearrangements, visual assesment, semiquantitative analysis of 18 F-FDG PET scans and patient survival analysis were performed in 61 DLBCL patients, treated at a single referral hospital between 2008 and 2015. Results: Of 61 tumours, 21 (34%) had a MYC rearrangement (MYC + ). MYC status was neither associated with the presence of necrosis on 18 F-FDG PET scans (necrosis PET ; p = 1.0) nor associated with the investigated semiquantitative parameters maximum standard uptake value (SUV max ; p = 0.43), single highest SUV max (p = 0.49), metabolic active tumour volume (MATV; p = 0.68) or total lesion glycolysis (TLG; p = 0.62). A multivariate patient survival analysis of the entire cohort showed necrosis PET as an independent prognostic marker for disease-specific survival (DSS) (HR = 13.9; 95% CI 3.0–65; p = 0.001). Conclusions: MYC rearrangements in DLBCL have no influence on the visual parameter necrosis PET or the semi-quantiative parameters SUV max , MATV and TLG. Irrespective of MYC rearrangements, necrosis PET is an independent, adverse prognostic factor for DSS. Key Points: • Retrospective analysis indicates that MYC rearrangement is not associated with necrosis on 18 F-FDG PET (necrosis PET ) scans or semiquantitative 18 F-FDG PET parameters. • Necrosis PET is a potential independent adverse prognostic factor for disease-specific survival in patients with DLBCL and is not influenced by the presence of MYC rearrangements.

AB - Objectives: MYC gene rearrangements in diffuse large B cell lymphomas (DLBCLs) result in high proliferation rates and are associated with a poor prognosis. Strong proliferation is associated with high metabolic demand and tumour necrosis. The aim of this study was to investigate differences in the presence of necrosis and semiquantitative 18 F-FDG PET metrics between DLBCL cases with or without a MYC rearrangement. The prognostic impact of necrosis and semiquantitative 18 F-FDG PET parameters was investigated in an explorative survival analysis. Methods: Fluorescence in situ hybridisation analysis for MYC rearrangements, visual assesment, semiquantitative analysis of 18 F-FDG PET scans and patient survival analysis were performed in 61 DLBCL patients, treated at a single referral hospital between 2008 and 2015. Results: Of 61 tumours, 21 (34%) had a MYC rearrangement (MYC + ). MYC status was neither associated with the presence of necrosis on 18 F-FDG PET scans (necrosis PET ; p = 1.0) nor associated with the investigated semiquantitative parameters maximum standard uptake value (SUV max ; p = 0.43), single highest SUV max (p = 0.49), metabolic active tumour volume (MATV; p = 0.68) or total lesion glycolysis (TLG; p = 0.62). A multivariate patient survival analysis of the entire cohort showed necrosis PET as an independent prognostic marker for disease-specific survival (DSS) (HR = 13.9; 95% CI 3.0–65; p = 0.001). Conclusions: MYC rearrangements in DLBCL have no influence on the visual parameter necrosis PET or the semi-quantiative parameters SUV max , MATV and TLG. Irrespective of MYC rearrangements, necrosis PET is an independent, adverse prognostic factor for DSS. Key Points: • Retrospective analysis indicates that MYC rearrangement is not associated with necrosis on 18 F-FDG PET (necrosis PET ) scans or semiquantitative 18 F-FDG PET parameters. • Necrosis PET is a potential independent adverse prognostic factor for disease-specific survival in patients with DLBCL and is not influenced by the presence of MYC rearrangements.

KW - Diffuse, large B cell, lymphoma

KW - Fluorodeoxyglucose F18

KW - MYC oncogene

KW - Necrosis

KW - Positron emission tomography

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85065151057&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31028445

U2 - https://doi.org/10.1007/s00330-019-06178-9

DO - https://doi.org/10.1007/s00330-019-06178-9

M3 - Article

C2 - 31028445

SN - 0938-7994

VL - 29

SP - 6018

EP - 6028

JO - European Radiology

JF - European Radiology

IS - 11

ER -

Tumour necrosis as assessed with 18 F-FDG PET is a potential prognostic marker in diffuse large B cell lymphoma independent of MYC rearrangements

Abstract

Keywords

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