Trial reportBritish journal of haematology2026
Metabolic heterogeneity-based radiomic model predicts treatment outcomes of primary mediastinal B-cell lymphoma patients in the IELSG37 study.
Trial report in British journal of haematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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11 authors.
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Abstract
Early identification of patients at risk of failing first-line therapy remains a key challenge in primary mediastinal B-cell lymphoma (PMBCL). This study assessed whether positron emission tomography (PET) radiomics could predict treatment outcomes in PMBCL. Baseline PET/computed tomography (CT) scans from 501 patients enrolled in the International Extranodal Lymphoma Study Group 37 (IELSG37) trial and treated with rituximab- and doxorubicin-based immunochemotherapy were analysed. Functional PET parameters reflecting tumour burden (metabolic tumour volume, MTV), glucose consumption (total lesion glycolysis, TLG) and metabolic heterogeneity (MH) were calculated using a 25% maximum standard uptake value (SUVmax) segmentation threshold. Radiomic analysis was performed in 495 patients, extracting 107 features; 74 features uncorrelated with SUVmax and MTV were selected and analysed using a recursive-partitioning classification tree (Ctree) approach. Ctree identified grey-level run-length matrix run variance (GLRLM-RV), a marker of MH, as the most significant prognostic feature. Patients with low MH (GLRLM-RV <0.136) had a 5-year progression-free survival (PFS) of 93%, compared with 65% in those with high MH (p < 0.0001). Five-year overall survival (OS) was 96% vs. 80% respectively (p < 0.0001). A subsequent Ctree model integrating GLRLM-RV and TLG further improved prognostic stratification for PFS and OS (p < 0.0001), outperforming established prognostic indices (International Prognostic Index [IPI], revised-IPI and age-adjusted IPI).
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