VIENNA -- Two novel quantitative F-18 FDG-PET/CT biomarkers, “MTV” and “Dmax,” may predict progression-free survival in lymphoma patients, according to research presented on 4 March at ECR 2026 in Vienna.
Yulduzkhan Dauytova, a PhD student from Almaty, Kazakhstan, presented research on 4 March at ECR 2026 in Vienna.
In a study involving 120 patients, metabolic tumor volume (MTV) and the maximum distance between the two most metabolically active lesions (Dmax) on baseline F-18 FDG-PET/CT independently predicted progression-free survival (PFS) and provided value beyond standard Deauville scores, noted presenter Yulduzkhan Dauytova, a PhD student at Kazakh National Medical University in Almaty, Kazakhstan.
“Combined use of parameters beyond Deauville, like MTV and Dmax, provide complimentary information and enhances risk stratification in patients with lymphoma,” Dauytova said.
F-18 FDG-PET/CT is indispensable in the management of lymphoma. The Deauville 5-point scale is based on uptake of F-18 FDG radiotracer by tumors, from no uptake (1) to markedly increased uptake compared with the liver (5), and remains the cornerstone for assessing patients, Dauytova explained.
Yet the Deauville scale often fails to capture the full biological heterogeneity of disease, and novel quantitative biomarkers such as MTV and Dmax may provide complementary insights into tumor burden and dissemination to improve treatment strategies, she added.
To test the predictive capabilities of these biomarkers, Dauytova and colleagues evaluated 120 patients with newly diagnosed Hodgkin or non-Hodgkin lymphoma who underwent serial F-18 FDG-PET/CT scans, including baseline staging, interim response assessments, end-of-treatment evaluation, and follow-up imaging. MTV was derived from semiautomated segmentation on the imaging, while Dmax was calculated as the Euclidean distance between the most distant FDG-avid lesions. MTV is the total volume of FDG-avid tumor, while Dmax reflects the dissemination of the disease, Dauytova noted.
The researchers stratified patients (average age, 50; 61% men) into high versus low MTV and Dmax groups, with Kaplan-Meier and multivariate Cox analyses performed with PFS as the primary endpoint.
According to the findings, patients with high baseline Dmax (> 30 cm) and high MTV had significantly inferior outcomes. The two-year PFS was 82% in the low-Dmax group versus 48% in the high-Dmax group (p < 0.01) and 80% in the low-MTV group versus 50% in the high-MTV group (p < 0.01).
On multivariate analysis, both Dmax and MTV remained independent predictors of PFS beyond interim PET response, Dauytova reported. Moreover, a combined model (Deauville + MTV + Dmax) achieved superior risk stratification, identifying a subgroup with poor prognosis despite negative interim PET findings, according to the results.
“MTV and Dmax extend the prognostic power of FDG-PET/CT beyond the Deauville scale. Their integration into routine reporting can refine risk stratification and support personalized treatment strategies in lymphoma,” Dauytova concluded.
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