DOI: 10.1097/mnm.0000000000002194 ISSN: 0143-3636

Prognostic value of baseline 18F- fluroodexoygloucose PET/computed tomography–derived maximum standardized uptake value and tumor bulk in pediatric Hodgkin lymphoma: a retrospective analysis

Nadia Nazir, Zeeshan Sikandar, Faiza Afzal, Aruba Nawaz Khattak, Anis Ur Rehman, Khalid Javed, Irfana Ishaq Sindhu

Objective

This study aimed to evaluate the prognostic significance of baseline 18 F-fluorodeoxyglucose PET/computed tomography–derived metabolic tumor volume (MTV) and maximum standardized uptake value (SUV max ) for treatment outcome in pediatric Hodgkin lymphoma.

Methods

We retrospectively analyzed 48 patients aged less than or equal to 18 years with newly diagnosed intermediate-risk Hodgkin lymphoma who underwent baseline 18 F-fluorodeoxyglucose PET/computed tomography between January 2020 and December 2025 at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan. Baseline MTV and SUV max were quantified and assessed for association with treatment outcomes. The primary endpoint was event-free survival (EFS).

Results

Median baseline MTV was 263.5 ml (range: 22–781) and median SUV max was 9.2 (range: 3.2–31.8). After a median follow-up of 48.8 months, 14 (29.2%) patients experienced an EFS event. MTV was higher in patients with events than in those without (303.0 vs. 254.5 ml), but the difference was not significant ( P = 0.212). SUV max was also nonpredictive ( P = 0.834). EFS was 63.6% in the high-MTV group versus 86.7% in the low-MTV group (Fisher’s exact P = 0.171; log-rank P = 0.194). MTV and SUV max showed a weak, nonsignificant correlation ( ρ = 0.173, P = 0.244). Disease stage was the only significant prognostic factor ( P = 0.010). Receiver operating characteristics analysis demonstrated modest discriminatory ability for MTV [area under the curve (AUC) = 0.617], whereas SUV max showed none (AUC = 0.479).

Conclusion

In this single-center cohort, baseline MTV and SUV max were not significantly predictive of EFS, with disease stage remained the only significant prognostic determinant. However, given the limited statistical power inherent to this sample size, a clinically meaningful association cannot be excluded and warrants evaluation in larger prospective studies.

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