Prognostic value of Deauville criteria and IHP criteria in 18F-FDG PET/CT for clinical evaluation at the end of treatment in diffuse large B-cell lymphoma

Objective To evaluate the diagnostic efficiency and prognostic value of 18F-fluorodeoxyglucose (FDG) PET/CT for response assessment after treatment in patients with diffuse large B-cell lymphoma (DLBCL) when using the Deauville criteria and International Harmonization Project (IHP) criteria. Methods A total of 212 patients (119 males, 93 males, average age: 59.6(10-88)years) with DLBCL from February 2010 to June 2018 were analyzed. All subjects underwent restaging PET/CT after treatment. Images were evaluated with the IHP criteria, Deauville score of 3-5 (DC3) and Deauville score of 4-5 (DC4). The diagnostic efficiency of the 3 criteria for treatment effect was assessed and follow-up results were used as the gold standard. Spearman rank correlation analysis was used. Progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan-Meier analysis and Cox proportional hazards model. Results The positive predictive value and accuracy of DC4 for treatment effect evaluation were 96.8%(61/63) and 94.3%(200/212), those of IHP criteria were 75.3%(67/89) and 87.7%(186/212) respectively, and those of DC3 were 82.9%(68/82) and 92.0%(195/212) respectively. IHP criteria results and Deauville scores were correlated(rs=0.926, P<0.05). The 2-year PFS rates in IHP-, DC3- and CD4-positive groups were 78.7%, 76.5% and 69.8%, respectively, and those in IHP-, DC3- and CD4-negative groups were significantly higher (95.6%, 94.7%, 97.2%; χ2=14.415, 18.293 and 26.920, all P<0.05). The similar results were found for OS rates (χ2=9.597, 11.149 and 17.416, all P<0.05). The 2-year PFS rates in Deauville score of 1, 2, 3, 4, 5 groups were 95.3%, 91.7%, 93.3%, 88.9% and 55.6% respectively (χ2=48.199, P<0.05). Cox-regression analysis showed significant correlation between Deauville criteria and 2-year PFS rate (P<0.05). Conclusions PET/CT with DC4, DC3 and IHP criteria have high predictive values for treatment outcome, and DC4 is the best. Cox regression analysis shows significant risk of progression by Deauville criteria. Key words: Lymphoma, large B cell, diffuse; Drug therapy, combination; Treatment outcome; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose