DLBCL
Purpose
Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous entity, with patients exhibiting a wide range of outcomes. Pre-therapeutic stratification is important because patients who are R-CHOP refractory have a very poor prognosis. Patients with poor prognostic characteristics should be offered first-line treatment with new targeted drugs in addition to R-CHOP. However, identification of poor responders is not possible with the Revised-International-Prognostic-Index(R-IPI) or IPI risk scores. Radiomics-analysis on [18]FDG-PET provides semi-quantitative features of tumor characteristics as intensity, shape, volume, localization and texture. Importantly, this [18]FDG-PET radiomics approach permits in-depth whole-body intra- and inter-tumor analyses, which is advantageous to histology analyses, which are typically based on a single biopsied lesion. Recent data suggest that radiomics features carry prognostic information in addition to clinical and genetic information.
Objectives
To identify potential prognostically relevant image characteristics for DLBCL patients
To assess the sensitivity of image characteristics to the variability of image quality
To assess the repeatability and reproducibility of the potential prognostically relevant image characteristics
To develop a prognostic model to predict 2 years of progression free survival in DLBCL patients
To assess the potential added prognostic significance of genomic
To clinically validate the prognostic model using the other clinical studies of the PETRA database
Overall aim
To identify and validate prognostic radiomics features (both at patient- and lesional level) from baseline PET-scans in DLBCL, and examine their performance in addition to R-IPI, and to genomic data. Such PET tools need to be robust, clinically applicable and technically well-characterized.
