Blood cancers

Diagnostic and prognostic tool shows promise for patients with follicular lymphoma


The measuring of total metabolic tumour volume (TMTV) using innovative add-on technology to PET scanning is showing potential as strong predictor of patient outcome and treatment prognosis for patients with follicular lymphoma, new research shows.

The study, published in the Journal of Clinical of Oncology, is the first major research to look closely at the prognostic possibilities of TMTV for patients with follicular lymphoma (FL), either on its own or used in conjunction with existing prognostic indices.

Australian haematologist, Associate Professor Judith Trotman, who was part of the research team, said TMTV was showing great promise as a prognostic and diagnostic tool.

Director of the Clinical Research Unit at the Concord Cancer Centre in Sydney, Professor Trotman been working closely with fellow researchers in France and Italy on the project, which was sparked by the realisation that current prognostic models were not able to satisfactorily identify patients with high-tumour burden FL  at high risk of progression and early death.

According to Professor Trotman one of the great advantages of the use of TMTV was the fact that it could be measured using add-on software to existing PET scanning.

It was proving effective in quantifying all the hottest areas of the lymphoma mass, by measuring the glucose acidity of every single part of the tumour.

“You’re getting more information out of the existing test,” Professor Trotman told the limbic. “And if you’re getting more information out of your prognostics and diagnostics, then that’s got to be a good thing”.

“It warrants further validation as a biomarker for development of first-line PET-adapted approaches in FL,” says the research team.

However Professor Trotman said that while the concept of measuring TMTV for diagnosis and prognosis seemed very simple, it required sophisticated software to maximise accuracy and efficacy and ensure that treatments were targeted for maximum benefit.

The next challenge for the researchers is to reproduce their data in large cohorts with prospective studies and then reliably replicate it in clinical studies.

Professor Trotman hopes a good outcome would lead to the development of internationally recognised standards to allow for the required TMTV thresholds to be applied to various types of FL.

Some low grade lymphomas may not prove suitable for the model although she expects this to be minimal.

“It’s too early to say that this is the answer to everything, but it has the potential to provide a single staging across many different lymphomas,” she said.

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