{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T03:09:28Z","timestamp":1785380968591,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,5,16]],"date-time":"2019-05-16T00:00:00Z","timestamp":1557964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000871","name":"Mayo Clinic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Predicting early clinical failure in patients with untreated follicular lymphoma (FL) is important but difficult. This study aimed to determine the incidence and patterns of extranodal (EN) and spleen disease using PET\/CT, and assess their utility in predicting early clinical failure. PET\/CT images from 613 cases of untreated FL (2003\u20102016) were reviewed. The location and number of EN sites, patterns of bone involvement, and splenic involvement were recorded. Outcomes were assessed using event\u2010free survival (EFS), overall survival (OS), and early clinical failure at 24\u2009months (EFS24). So, 49% (301\/613) of patients had PET\/CT\u2010detected EN involvement, and 28% (171\/613) had spleen involvement. The presence of \u22652 EN sites, spleen, bone or soft tissue involvement all predicted failure to achieve EFS24. Presence of \u22652 EN sites and bone involvement pattern were also predictive of OS in a univariate analysis. In a multivariate analysis with FLIPI\u20102 factors, spleen involvement, pattern of bone involvement, and soft tissue involvement independently predicted a lower EFS (HR 1.49 (1.11\u20102.00),<jats:italic>P<\/jats:italic>= .007; HR 1.71 (1.10\u20102.65),<jats:italic>P<\/jats:italic>= .017; and HR 1.67 (1.06\u20102.62),<jats:italic>P<\/jats:italic>= .026, respectively). When the multivariate analysis was performed using PRIMA\u2010PI factors (marrow and B2M), the number of EN sites was an independent prognostic factor for inferior OS (HR 2.28;<jats:italic>P<\/jats:italic>= .05). Baseline PET\/CT identifies EN involvement in nearly half of patients with untreated FL. The presence of \u22652 EN sites, bone, soft tissue, or splenic involvement predicts early clinical failure. These results, when combined with other factors, may better identify high\u2010risk patients and guide therapy.<\/jats:p>","DOI":"10.1002\/ajh.25493","type":"journal-article","created":{"date-parts":[[2019,4,22]],"date-time":"2019-04-22T04:24:08Z","timestamp":1555907048000},"page":"786-793","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Detection of extranodal and spleen involvement by FDG\u2010PET imaging predicts adverse survival in untreated follicular lymphoma"],"prefix":"10.1002","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8495-8579","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9rique","family":"St\u2010Pierre","sequence":"first","affiliation":[{"name":"Department of Medicine Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen M.","family":"Broski","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Nuclear Radiology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Betsy R.","family":"LaPlant","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research, Division of Biomedical Statistics and Informatics Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Ristow","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Maurer","sequence":"additional","affiliation":[{"name":"Department of Health Sciences Research, Division of Biomedical Statistics and Informatics Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R.","family":"Macon","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas M.","family":"Habermann","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1244-6758","authenticated-orcid":false,"given":"Stephen M.","family":"Ansell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie A.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Hematology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivana N. 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