A novel prognostic model utilizing TMTV and SUVmax from 18F-FDG PET/CT for predicting overall survival in patients with extranodal NK/T- cell lymphoma

作者：Hua Wang, Demei Feng, Yiwen Mo, Huangming Hong, Yingying Hu, Li Huang, Xiaolei Wei, Yajun Li, Haibin Huang, Runhui Zheng, Yonghua Li, Hui Zeng, Robert Peter Gale, Ying Tian, Jing Guo, Zhenshu Xu, Wei Fan, Tong-Yu Lin · 发表于：BMC Cancer · 年份：2025 · DOI：10.1186/s12885-025-13725-9 · 被引用次数：3 · 研究领域：Lymphoma Diagnosis and Treatment、CNS Lymphoma Diagnosis and Treatment、Immune Cell Function and Interaction

Survival prediction accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in extra-nodal natural killer/T-cell lymphoma (ENKTL) is controversial. This study aimed to evaluate the prognostic value of 18 F-FDG PET/CT parameters including maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG), and to develop a new prognostic model for ENKTL. We analyzed 390 ENKTL patients with comprehensive clinical and survival data. All patients received asparaginase-based chemotherapy with or without radiotherapy, or radiotherapy alone. Metabolic tumor volume (MTV) was calculated using a 41% SUVmax threshold, and TLG was computed as MTV multiplied by the average SUV. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan–Meier curves and compared with log-rank tests. Optimal cut-off values were determined using the Youden’ index. Cox regression analysis identified significant prognostic factors. A nomogram predicting 1-, 3-, and 5-year survival was developed and validated using the C-index and calibration curves. Statistical significance was set at p < 0.05. Of the 390 patients, 262 (67.2%) were included in the training set and 128 (32.8%) in the validation set. 18 F-FDG PET-CT parameters with cutoff values of SUVmax > 12.8, TMTV > 16.4 cm 3 , and TLG > 137.0, were significantly associated with poorer OS ( p = 0.009) and PFS ( p = 0.003). Multivaria...