{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T08:39:44Z","timestamp":1775032784648,"version":"3.50.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Total metabolic tumor volume (TMTV) in <jats:sup>18<\/jats:sup>F-fluorodeoxyglucose (FDG) positron emission tomography (PET) predicts patient outcome in follicular lymphoma (FL); however, it requires laborious segmentation of all lesions. We investigated the prognostic value of the metabolic bulk volume (MBV) obtained from the single largest lesion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Pretreatment FDG PET\/computed tomography (CT) scans of 201 patients were analyzed for TMTV and MBV using a 41% maximum standardized uptake value (SUVmax) threshold.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During a median follow-up of 3.2 years, 54 events, including 14 deaths, occurred. Optimal cut-offs were 121.1 cm<jats:sup>3<\/jats:sup> for TMTV and 24.8 cm<jats:sup>3<\/jats:sup> for MBV. Univariable predictors of progression-free survival (PFS) included a high Follicular Lymphoma International Prognostic Index 2 (FLIPI2) score, TMTV, and MBV. In the multivariable analysis, high TMTV and MBV were independent predictors of worse PFS (<jats:italic>P<\/jats:italic> =0.015 and 0.033). Furthermore, in a sub-group with FLIP2 scores of 0\u20132 (<jats:italic>n<\/jats:italic> = 132), high MBV could identify patients with worse PFS (<jats:italic>P<\/jats:italic> = 0.007).\u2003<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Readily measurable MBV is useful for stratifying risk in FL patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1283582","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T10:25:31Z","timestamp":1699007131000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Metabolic bulk volume from FDG PET as an independent predictor of progression-free survival in follicular lymphoma"],"prefix":"10.3389","volume":"13","author":[{"given":"Heejune","family":"So","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyunjong","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung Hyup","family":"Hyun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Seok","family":"Cho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung Hwan","family":"Moon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon Young","family":"Choi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung-Han","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/PPO.0000000000000444","article-title":"Advances in treatment of follicular lymphoma","volume":"26","author":"Caimi","year":"2020","journal-title":"Cancer J"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.7534","article-title":"Early relapse of follicular lymphoma after rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone defines patients at high risk for death: An analysis from the National Lymphocare Study","volume":"33","author":"Casulo","year":"2015","journal-title":"J Clin 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progression","volume":"104","author":"Seymour","year":"2019","journal-title":"Haematologica"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019003526","article-title":"High total metabolic tumor volume at baseline predicts survival independent of response to therapy","volume":"135","author":"Vercellino","year":"2020","journal-title":"Blood"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-014-2961-x","article-title":"FDG PET\/CT: EANM procedure guidelines for tumour imaging: version 2.0","volume":"42","author":"Boellaard","year":"2015","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.18016","article-title":"Pre-treatment total metabolic tumour volumes in lymphoma: Does quantity matter","volume":"197","author":"El-Galaly","year":"2022","journal-title":"Br J Haematol"}],"container-title":["Frontiers in 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