Purpose

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous entity, with patients exhibiting a wide range of outcomes.  Pretherapeutic stratification is important because disease resistant to R-CHOP has a very poor prognosis, because of refractoriness to current second-line regimens. Patients with poor prognostic characteristics should be offered first-line treatment with new targeted drugs in addition to R-CHOP. However, this is not possible with the Revised-International-Prognostic-Index(R-IPI)(1), which combines clinical, laboratory and CT information. Radiomics-analysis of imaging data provides quantitative features of tumor characteristics as intensity, shape, volume, localization and texture. Importantly, radiomics by a whole body PET/CT allows to assess intra-and inter-tumor heterogeneity , in contrast to biopsy of a single lesion. Recent data suggest that radiomics-features carry prognostic information in addition to genetic information.

Objectives

  • To identify potential prognostically relevant PET-CT image characteristics for DLBCL patients

  • To assess the sensitivity of image characteristics to the variability of image quality

  • To assess the repeatability and reproducability of the potential prognostically relevant image characteristics

  • To develop a prognostic model to predict 24 months progression free survival in DLBCL patients

  • To assess the potential added value of predictions from genomic features

  • To clinically validate the prognostic model using the other clinical studies of the PETRA database