20.500.12556/DiRROS-24002 Prognostic Value of Multiple Manual Segmentation Methods for Diffuse Large B-Cell Lymphoma with 18F-FDG PET/CT Abstract: Quantitative 18F-FDG PET/CT-derived metabolic metrics are strongly associated with patient outcomes in diffuse large B-cell lymphoma (DLBCL), but the lack of consensus on optimal segmentation thresholds limits standardization. This study evaluated the prognostic value of various metabolic tumor volume (MTV) segmentation approaches in 140 stage II–IV DLBCL patients treated with standard immunochemotherapy. MTV was derived using fixed SUV (≥2.5, ≥4.0), relative (>41% SUVmax), and adaptive (liver-tobackground) thresholds. Baseline MTV metrics significantly correlated with 3-year overall survival (OS3) in univariate analysis in overall cohort, with MTV41 showing the strongest association (HR: 1.27; p = 0.003). MTV25 and MTV41 remained significant in the stage 4 patient subgroup. However, in multivariate analysis, no MTV metric independently predicted OS3 when adjusted for the International Prognostic Index (IPI), which remained the dominant predictor (HR: 1.95; p < 0.0001). ROC analysis confirmed superior AUC for IPI (0.76) over PET-based metrics (0.64–0.69). Predictive models integrating IPI with PET metrics were robust but failed to improve prognostic accuracy beyond IPI alone. Although PET-derived MTV metrics provide prognostic value in univariate analysis, threshold selection has minimal impact, and their added value is limited when combined with IPI, reinforcing its role as the most reliable survival predictor in DLBCL. diffuse large B-cell lymphoma 18F-FDG overall survival PET/CT difuzni velikocelični B-limfom 18F-FDG PET/CT celokupno preživetje PET/CT true false true MDPI, Basel, Switzerland Basel, Switzerland Angleški jezik Slovenski jezik by Authors Neznano 2025-11-06 03:38:24 2025-11-21 14:29:27 2025-11-22 03:42:22 0000-00-00 00:00:00 2025 0 Basel 0 Nasl. z nasl. zaslona; Opis vira z dne 30. 6. 2025; str. 356-1-356-17 Vol. 32 2025 0000-00-00 Zaloznikova Objavljeno apc 2025-02-18 2025-06-16 2025-06-16 616.1 1718-7729 10.3390/curroncol32060356 240809731 https://www.mdpi.com/1718-7729/32/6/356/pdf 1 ab620b72-bab9-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=35655 Onkološki inštitut Ljubljana 0 0 0