{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T15:51:10Z","timestamp":1793029870390,"version":"4.5.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T00:00:00Z","timestamp":1763769600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Klinikum der Universit\u00e4t M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cancer Imaging"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>CD19-specific chimeric antigen receptor T-cell therapy (CART) has emerged as effective treatment for relapsed or refractory (r\/r) lymphoma. The maximum distance (Dmax) of lymphoma lesions holds potential as prognostic imaging biomarker in lymphoma treated with conventional therapies, but evidence in the context of CART remains scarce and further studies are needed to clarify its clinical relevance. We evaluated Dmax at baseline imaging as a potential prognostic tool for assessment of metabolic and overall response, progression-free survival (PFS) and overall survival (OS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material &amp; methods<\/jats:title>\n                    <jats:p>Consecutive r\/r lymphoma patients with (PET\/)CT imaging at baseline (BL) before lymphodepletion and subsequent CAR T-cell transfusion were included. Dmax was measured in cm at BL. Patients were divided by tertiles into three equal sized groups according to Dmax. Ann Arbor stages were calculated at baseline and the sum of product diameters (SPD) was used to represent tumor burden (TB). Overall response according to Lugano criteria and the Deauville score were determined at day 90 PET\/CT imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-nine patients met the inclusion criteria. Median Dmax was 40.0\u00a0cm (IQR: 16.4\u201370.3\u00a0cm) at BL. Median TB decreased from BL with 4,095 mm\n                      <jats:sup>2<\/jats:sup>\n                      to 770 mm\n                      <jats:sup>2<\/jats:sup>\n                      at FU imaging. Median TB at BL was significantly higher in the Dmax intermediate and high group compared to the Dmax low group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) with 7,222 mm\n                      <jats:sup>2<\/jats:sup>\n                      (IQR: 3,355\u201311,941 mm\n                      <jats:sup>2<\/jats:sup>\n                      ), 4,649 mm\n                      <jats:sup>2<\/jats:sup>\n                      (IQR: 2,376\u201310,406 mm\n                      <jats:sup>2<\/jats:sup>\n                      ) and 1,739 mm\n                      <jats:sup>2<\/jats:sup>\n                      (IQR: 715\u20137,402 mm\n                      <jats:sup>2<\/jats:sup>\n                      ), respectively. Dmax intermediate and high group showed significantly higher Ann Arbor stages (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The survival analysis revealed a significantly (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030) shorter PFS in the Dmax high group compared to the other patients (91 vs. 364 days), but no relevant differences in OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.151).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with high Dmax showed a shorter PFS, but no significant differences in OS. Dmax is a useful parameter for characterizing tumor dissemination, which could also be incorporated into scores due to its interval scale.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40644-025-00959-w","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T04:05:29Z","timestamp":1763784329000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predictive value of maximum tumor dissemination (Dmax) in lymphoma patients treated with CD19-specific CAR T-Cells"],"prefix":"10.1186","volume":"25","author":[{"given":"Michael","family":"Winkelmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Achhammer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktoria","family":"Blumenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Rejeski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veit L.","family":"B\u00fccklein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel T.","family":"Sheikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Brendel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Ricke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"von Bergwelt-Baildon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Subklewe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang G.","family":"Kunz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,22]]},"reference":[{"key":"959_CR1","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1056\/NEJMra1706169","volume":"379","author":"CH June","year":"2018","unstructured":"June CH, Sadelain M. 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K.R.: Kite\/Gilead: Research Funding, Consultancy, Honoraria and travel support; Novartis: Honoraria; BMS\/Celgene: Consultancy, Honoraria; Pierre-Fabre: travel support. V.L.B.: Amgen: Honoraria; Celgene\/BMS: Research Funding; Kite\/Gilead: Research Funding, Honoraria; Novartis: Honoraria; Pfizer: Honoraria. C.S.: Kite\/Gilead: Travel Support. M.B.: Life Molecular Imaging: Consultancy, Honoraria; MIAC: Consultancy, Honoraria; GE healthcare: Consultancy, Honoraria; Roche: Consultancy, Honoraria; Life Molecular Imaging: Honoraria. M.v.B.: Astellas: Consultancy, Research Funding and Honoraria; BMS: Consultancy, Research Funding and Honoraria; Kite\/Gilead: Consultancy, Research Funding and Honoraria; Miltenyi: Consultancy, Research Funding and Honoraria; Mologen: Consultancy, Research Funding and Honoraria; MSD Sharp & Dohme: Consultancy, Research Funding and Honoraria; Novartis: Consultancy, Research Funding and Honoraria; Roche: Consultancy, Research Funding and Honoraria. M.S.: Amgen: Research Funding, Speakers Bureau; Astra Zeneca: Speakers Bureau; Aven Cell: Consultancy, BMS\/Celgene: Research Funding, Speakers Bureau; CDR-Life: Consultancy, Gilead: Research Funding, Speakers Bureau; GSK: Speakers Bureau; Ichnos Sciences: Consultancy; Incyte Biosciences: Consultancy; Janssen: Research Funding, Consultancy, Speakers Bureau; Miltenyi Biotec: Research Funding, Consultancy; Morphosys: Research Funding; Molecular Partners: Consultancy; Novartis: Research Funding, Consultancy, Speakers Bureau; Pfizer: Consultancy, Speakers Bureau; Roche: Research Funding, Speakers Bureau; Seattle Genetics: Research Funding; Takeda: Research Funding, Consultancy, Speakers Bureau. W.G.K.: Bristol Myers Squibb: Advisor; Boehringer Ingelheim: Advisor; mintMedical: Advisor, Need, Inc.: Advisor. The remaining authors declare no competing financial interests. None of the mentioned conflicts of interest were related to financing of the content of this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"135"}}