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Purpose <p>We aimed to assess therapy response and prognosis of pediatric patients with Burkitt lymphoma (BL) using [<sup>18</sup>F] Fluorodeoxyglucose positron emission tomography/computed tomography [<sup>18</sup>F] FDG PET/CT metabolic indices, including whole body metabolic tumor volume (wbMTV), whole body total lesion glycolysis (wbTLG), mean standardized uptake value (SUV<sub>mean</sub>) and maximum standardized uptake value (SUV<sub>max</sub>).</p> Methods <p>We analyzed 98 pediatric patients with Burkitt lymphoma who underwent [¹⁸F] FDG PET/CT at baseline and after completion of therapy. Quantitative metabolic parameters, including the hottest lesion SUVmax (SUVmax-HL), hottest lesion SUVmean (SUVmean-HL), whole-body metabolic tumor volume (wbMTV), and whole-body total lesion glycolysis (wbTLG), were evaluated. Patients were followed for up to three years. Univariate Cox regression analyses were used to identify PET/CT parameters and clinical factors associated with event-free and overall survival. EFS and OS were defined as the time from chemotherapy initiation to the first event or death, respectively, or last follow-up. Optimal cut-offs were determined using ROC curve analysis, and survival differences were analyzed by Kaplan–Meier and log-rank tests.</p> Results <p>wbMTV and wbTLG differed significantly between therapy response groups (<i>p</i> &lt; 0.001 and <i>p</i> = 0.002, respectively), whereas hottest lesion SUVmax and SUVmean showed no significant differences. In univariate analysis, wbMTV and wbTLG were associated with event-free survival (EFS) (<i>p</i> = 0.002 and <i>p</i> = 0.008, respectively). Among clinical variables, CNS involvement (<i>p</i> = 0.048) and bulky disease (<i>p</i> = 0.015) were also linked to poorer EFS, while other PET/CT and clinical parameters were not. No PET/CT or clinical variables were significantly related to overall survival (OS).</p> Conclusion <p>Therapy response was significantly associated with baseline wbMTV and wbTLG. In addition, these PET/CT parameters, along with CNS involvement and bulky disease, were linked to poorer event-free survival, indicating possible prognostic relevance. No variables significantly influenced overall survival. Given the small number of events, validation in larger prospective studies, including multivariate analyses, is warranted.</p>

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Prognostic value of quantitative metabolic indices in baseline [18F] FDG PET/CT for pediatrics Burkitt’s lymphoma

  • 期刊论文

  • 发表日期：

    2026年5月23日

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  • Aya Salah,
  • Marwa Romeih,
  • Clemens Mingels,
  • Asmaa Hamoda,
  • Eman NasrEldin,
  • Iman Zaky,
  • Esraa Roshdy

摘要

Purpose

We aimed to assess therapy response and prognosis of pediatric patients with Burkitt lymphoma (BL) using [18F] Fluorodeoxyglucose positron emission tomography/computed tomography [18F] FDG PET/CT metabolic indices, including whole body metabolic tumor volume (wbMTV), whole body total lesion glycolysis (wbTLG), mean standardized uptake value (SUVmean) and maximum standardized uptake value (SUVmax).

Methods

We analyzed 98 pediatric patients with Burkitt lymphoma who underwent [¹⁸F] FDG PET/CT at baseline and after completion of therapy. Quantitative metabolic parameters, including the hottest lesion SUVmax (SUVmax-HL), hottest lesion SUVmean (SUVmean-HL), whole-body metabolic tumor volume (wbMTV), and whole-body total lesion glycolysis (wbTLG), were evaluated. Patients were followed for up to three years. Univariate Cox regression analyses were used to identify PET/CT parameters and clinical factors associated with event-free and overall survival. EFS and OS were defined as the time from chemotherapy initiation to the first event or death, respectively, or last follow-up. Optimal cut-offs were determined using ROC curve analysis, and survival differences were analyzed by Kaplan–Meier and log-rank tests.

Results

wbMTV and wbTLG differed significantly between therapy response groups (p < 0.001 and p = 0.002, respectively), whereas hottest lesion SUVmax and SUVmean showed no significant differences. In univariate analysis, wbMTV and wbTLG were associated with event-free survival (EFS) (p = 0.002 and p = 0.008, respectively). Among clinical variables, CNS involvement (p = 0.048) and bulky disease (p = 0.015) were also linked to poorer EFS, while other PET/CT and clinical parameters were not. No PET/CT or clinical variables were significantly related to overall survival (OS).

Conclusion

Therapy response was significantly associated with baseline wbMTV and wbTLG. In addition, these PET/CT parameters, along with CNS involvement and bulky disease, were linked to poorer event-free survival, indicating possible prognostic relevance. No variables significantly influenced overall survival. Given the small number of events, validation in larger prospective studies, including multivariate analyses, is warranted.