A prognostic index integrating deep learning baseline PET/CT biomarkers and multi-omics profiling in diffuse large B cell lymphoma

作者：Yue Wang, Xue Wang, Xin‐Yun Huang, Hongmei Jing, Songfu Jiang, He Li, Rongji Mu, Qing Shi, Di Fu, Zhuo-Han Li, Hongmei Yi, Binshen Ouyang, Biao Li, Fuhua Yan, Ting Niu, Shu Cheng, Li Wang, Ning Wen, Peng-Peng Xu, Weili Zhao · 发表于：Cell Reports Medicine · 年份：2025 · DOI：10.1016/j.xcrm.2025.102452 · 被引用次数：3 · 研究领域：Lymphoma Diagnosis and Treatment、Radiomics and Machine Learning in Medical Imaging、Cancer Immunotherapy and Biomarkers

[ 18 F]-Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) is essential for disease staging and treatment response evaluation in diffuse large B cell lymphoma (DLBCL). In this study, we analyze 18 F-FDG-PET scans from 1,024 newly diagnosed DLBCL patients, integrating with DNA and RNA sequencing data. Using the nnUNet deep learning framework and training on both AutoPET public and in-house datasets, we identify key baseline biomarkers—including total metabolic tumor volume (TMTV), Max MTV, and the standardized tumor dissemination biomarker—that demonstrate significant prognostic value. Further integrating PET biomarkers with clinical factors and LymphPlex genetic subtypes, we develop high TMTV, elevated lactate dehydrogenase (LDH), and EZB-like MYC+, MCD-like, and TP53 Mut subtypes as risk factors to form the ClinicalPET LymphPlex model, efficiently distinguishing patient outcomes across different treatments. Notably, high TMTV correlates with an immunosuppressive tumor microenvironment, while elevated LDH is linked to increased metabolic activity and tumor proliferation. Collectively, our findings necessitate multimodal integration to enhance prognostic precision and advance personalized therapy in DLBCL. • Deep learning automates baseline PET biomarker extraction in 1,024 patients with DLBCL • A clinical-imaging-multi-omics prognostic index is developed and cross-validated • High TMTV and LDH correlate immunosuppressive microenvironment and ...