ArticleLa Radiologia medica2026
Splenic FDG PET uptake and CT volume as prognostic biomarkers in diffuse large B cell lymphoma.
Article in La Radiologia medica, 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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Abstract
objectivesTo evaluate whether baseline splenic ^18F-FDG PET uptake and CT-derived spleen volume predict early progression (≤ 36 months) and progression-free survival (PFS) in diffuse large B cell lymphoma (DLBCL), and whether they interact. MATERIALS AND
methodsRetrospective cohort of adults with newly diagnosed DLBCL undergoing baseline ^18F-FDG PET/CT and CT. Splenic PET positivity was defined visually (uptake exceeding hepatic background); spleen volume was measured semi-automatically. Early progression/relapse was analysed as a 36-month milestone endpoint and PFS as time-to-event. Multivariable logistic and Cox models included IPI, sex, treatment, splenic PET, spleen volume, and a PET × volume interaction. A prespecified PFS sensitivity analysis re-included event-free patients censored before 36 months.
results124 patients were included (68 men; median age 68 years [IQR 57-77]); 45/124 (36.3%) were PET-positive; median spleen volume was 3.13 dL (IQR 1.92-5.79). IPI predicted ≤ 36-month progression (OR 1.52; p = 0.021) and PFS (HR 1.44; p = 0.004). Splenic PET positivity predicted ≤ 36-month progression (OR 2.83; p = 0.048) but not PFS (p = 0.103). The PET × volume interaction was significant (OR 0.70; p = 0.021; HR 0.81; p = 0.033). In PET-negative patients, larger spleen volume predicted higher risk (OR 1.42; p = 0.027; HR 1.22; p = 0.042), whereas volume was neutral in PET-positive cases. In the PFS sensitivity analysis (N = 145), the interaction attenuated (HR 0.83; p = 0.057) and the PET-negative volume effect was borderline (HR 1.21; p = 0.053).
conclusionSplenic PET positivity is a dominant risk marker in DLBCL in this cohort. CT-derived spleen volume may add conditional prognostic information in PET-negative patients, but the incremental value of the PET × volume interaction is modest and requires external validation.
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