Up to one-third of diffuse large B-cell lymphoma (DLBCL) patients fail to achieve complete remission during first-line treatment or experience relapse. Salvage treatment regimens lead to modest cure rates Therefore, more accurate prognostic markers are essential to identify patients at high risk for progression or relapse. These poor responders might benefit from an early switch to novel therapies aiming to improve outcome.

In lymphoma, the baseline PET/CT scan is currently used for staging of the disease. Semi-quantitative tumor-related FDG PET parameters, especially baseline metabolic tumor volume (MTV), have shown to be predictive of outcome, as MTV reflects the FDG avid tumor burden in patients.


  • To identify the optimal semi-automated segmentation method or methods approach to delineate DLBCL lesions at baseline, iPET and EoT

  • To determine the best expression of the relationship between MTV and survival

  • To compare MTV with IPI categories for prediction of outcome

  • To compare the combination of MTV with individual IPI components to decide on the best predictive model

  • To explore the added value of MTV assessments at iPET and EoT to further improve clinical outcome predicting


Mikhaeel, N. G., Heymans, M. W., Eertink, J. J., de Vet, H., Boellaard, R., Dührsen, U., Ceriani, L., Schmitz, C., Wiegers, S. E., Hüttmann, A., Lugtenburg, P. J., Zucca, E., Zwezerijnen, G., Hoekstra, O. S., Zijlstra, J. M., & Barrington, S. F. (2022). Proposed New Dynamic Prognostic Index for Diffuse Large B-Cell Lymphoma: International Metabolic Prognostic Index. Journal of clinical oncology: official journal of the American Society of Clinical Oncology, JCO2102063. https://doi.org/10.1200/JCO.21.02063

Barrington, S. F., Zwezerijnen, B., de Vet, H., Heymans, M. W., Mikhaeel, N. G., Burggraaff, C. N., Eertink, J. J., Pike, L. C., Hoekstra, O. S., Zijlstra, J. M., & Boellaard, R. (2021). Automated Segmentation of Baseline Metabolic Total Tumor Burden in Diffuse Large B-Cell Lymphoma: Which Method Is Most Successful? A Study on Behalf of the PETRA Consortium. Journal of nuclear medicine : official publication, Society of Nuclear Medicine62(3), 332–337. https://doi.org/10.2967/jnumed.119.238923

Zwezerijnen GJ, Eertink JJ, Burggraaff CN, et al. (2021) Interobserver agreement in automated metabolic tumor volume measurements of Deauville score 4 and 5 lesions at interim (18)F-FDG PET in DLBCL. J Nucl Med. 2021 https://doi.org/10.2967/jnumed.120.258673

Burggraaff, C. N., Rahman, F., Kaßner, I., Pieplenbosch, S., Barrington, S. F., Jauw, Y., Zwezerijnen, G., Müller, S., Hoekstra, O. S., Zijlstra, J. M., De Vet, H., Boellaard, R., & PETRA Consortium (2020). Optimizing Workflows for Fast and Reliable Metabolic Tumor Volume Measurements in Diffuse Large B Cell Lymphoma. Molecular imaging and biology22(4), 1102–1110. https://doi.org/10.1007/s11307-020-01474-z