{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T10:46:29Z","timestamp":1792406789116,"version":"4.4.0"},"reference-count":55,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hematological Oncology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      Metabolic tumor volume (TMTV) is a core\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FDG PET\/CT prognostic marker for diffuse large B\u2010cell lymphoma (DLBCL), but its complex measurement and limited standardization restrict clinical utility. Metabolic tumor area (MTA) features simple operation and good reproducibility, holding potential as a practical alternative to TMTV. This retrospective study aimed to validate MTA's substitutability and explore its prognostic value in DLBCL risk stratification. A total of 295 newly diagnosed DLBCL patients were enrolled. TMTV and MTA were measured via semi\u2010automatic segmentation (41% SUVmax threshold). Survival analysis, Cox regression, 5\u2010fold cross\u2010validation, and time\u2010dependent ROC curves were used to evaluate prognostic performance. Multivariate analysis revealed MTA, rather than TMTV, independently predicted progression\u2010free survival (PFS) and overall survival (OS) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), with stability confirmed by cross\u2010validation. The combined MTA and\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      model provided IPI\u2010independent prognostic value, and exhibited improved predictive capacity compared with conventional IPI and TMTV and\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      model in non\u2010high\u2010risk IPI patients (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). It successfully identified occult high\u2010risk subgroups that were undetectable by standard IPI grading. MTA possesses favorable prognostic performance and may serve as a practical alternative to TMTV for DLBCL assessment. The MTA and\n                      <jats:italic>D<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      model complements the traditional IPI system, facilitating refined risk stratification and individualized clinical management. Further validation in multi\u2010center prospective cohorts is warranted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Ethics Committee of Jiangsu Cancer Hospital (Approval KY\u20102025\u2010095, 16 July 2025)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hon.70243","type":"journal-article","created":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:55:40Z","timestamp":1787500540000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic Tumor Area: A Clinically Practical Prognostic Marker for Improved Risk Stratification in IPI Non\u2010High\u2010Risk DLBCL"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-8914-196X","authenticated-orcid":false,"given":"Silu","family":"Cui","sequence":"first","affiliation":[{"name":"Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0260-9759","authenticated-orcid":false,"given":"Qi","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of PET\/CT Center Jiangsu Cancer Hospital and Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faquan","family":"Ji","sequence":"additional","affiliation":[{"name":"Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine  Nanjing 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