@article{QIMS155025,
author = {Qinwen Shi and Chong Jiang and Huijun Zhou and Minggang Su},
title = {Prognostic value of lesion dissemination on 18F-FDG PET/CT in patients with nasal-type extranodal natural killer/T-cell lymphoma},
journal = {Quantitative Imaging in Medicine and Surgery},
volume = {16},
number = {7},
year = {2026},
keywords = {},
abstract = {Background: Recent research suggests that the maximum distance between the two farthest tumor lesions (Dmax)—an indicator reflecting the degree of tumor dispersion—has prognostic value in certain lymphoma subtypes. This study aimed to explore the prognostic value of positron emission tomography/computed tomography (PET/CT) imaging features, particularly Dmax, in patients with advanced-stage nasal-type extranodal natural killer/T-cell lymphoma (ENKTL).Methods: A retrospective analysis was conducted. Using LIFEx software (version 7.3.0), imaging parameters, including the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and whole-body tumor Dmax, were measured. The optimal cut-off values for each parameter in predicting prognosis were determined using X-tile software. Cox regression analysis and the log-rank test were used to evaluate the prognostic value of each imaging parameter and clinical characteristic [gender, B symptoms, and Prognostic Index of Natural Killer cell lymphoma (PINK) score], and to identify independent prognostic factors.Results: A total of 104 patients with stage III/IV nasal-type ENKTL were enrolled in the study, which had a median follow-up duration of 98.6 months (interquartile range, 42.8–119.8). During follow-up, 70 patients experienced disease progression, and 56 died. Multivariate Cox regression analysis revealed that TLG was an independent risk factor for both progression-free survival (PFS) [hazard ratio (HR) =2.87, P=0.009] and overall survival (OS) (HR =2.66, P=0.044). After excluding TLG and MTV, which are difficult to obtain in routine clinical practice, Dmax remained an independent risk factor for PFS (HR =1.78, P=0.040) and OS (HR =1.83, P=0.044).Conclusions: When all the 18F-fluorodeoxyglucose (FDG) PET/CT parameters were analyzed together, Dmax was not an independent prognostic factor in patients with advanced-stage nasal-type ENKTL. However, after excluding MTV and TLG, which are difficult to obtain in routine clinical practice, Dmax independently predicted patient prognosis.},
issn = {2223-4306}, url = {https://qims.amegroups.org/article/view/155025}
}