To investigate whether pretherapy metabolic volumetric measurements may serve as a better prognostic tool than staging and early therapy response in classical Hodgkin lymphoma (cHL) and diffuse large B cell lymphoma (DLBCL).

Retrospective evaluation of 60 newly diagnosed cHL (n=26) or DLBCL (n=34) pts, all stages (III-IV:55%). Eligibility:PET/CT prior to and after 1-2 cycles (PET1-2) of standard of care (SOC) therapy, imaging at 60min+15 min after injection, follow-up (fu) >12 mo. At baseline, MTV, total lesion glycolysis (TLG), SUVmax were determined using a semiautomatic method;42% threshold for segmentation. At PET1-2, data were evaluated with Deauville criteria, %SUV decrease was also calculated. Variables were correlated with 2-yr progression free survival (PFS). A subgroup analysis for cHL, DLBCL was done.

In the entire cohort, median fu: 34mo, 2-year PFS: 82% (median,NR). Of 60 pts, 10 (16%) relapsed. As continuous variables, MTV, TLG, SUVmax, were not associated with PFS. As binary variables above or below the median, results are shown in the Table. MTV had a borderline, PET1-2 Deauville & %SUV decrease had significant associations with 2-yr PFS. Results for subgroups were similar.

Assessment of baseline MTV appears to be more predictive than Ann Arbor staging in cHL and DLBCL pts undergoing SOC therapy. However, Deauville criteria & %SUV decrease at PET1-2 are better predictors for PFS than baseline MTV. Considering MTV as a pretherapy prognostic marker, however, it may risk-stratify pts with potential management benefits. Although, these are promising data, further validation for each entity in prospective series is warranted