Reston, VA (April 22, 2026)-- Metabolic tumor volume--a biomarker derived from PET imaging--can more accurately predict progression-free survival for large B-cell lymphoma patients than the widely used International Prognostic Index. By identifying patients who are more likely to have poor outcomes early, the PET biomarker can contribute to the individualization of therapies. This research was published in The Journal of Nuclear Medicine .
Chimeric antigen receptor (CAR) T-cell therapy, a novel treatment approach that has been rapidly adopted by regulatory agencies, has substantially changed the management of patients with relapsed and refractory large B-cell lymphoma. While this cellular therapy has reshaped the treatment landscape for large B-cell lymphoma, patient stratification remains a challenge.
"CAR T-cell therapy has significantly advanced the treatment of large B-cell lymphoma; however, it s still unclear what baseline parameters and infusion time point are optimal," said Conrad-Amadeus Voltin, MD, nuclear medicine physician at the University Hospital Cologne, Cologne, Germany. "Quantitative PET biomarkers such as metabolic tumor volume may provide valuable information that can play a central role in personalized treatment planning."
In the study, Voltin and colleagues analyzed data from six European academic centers, encompassing 111 patients who underwent PET imaging before CAR T-cell therapy. The researchers used metabolic tumor volume derived from the PET scans to predict progression-free survival. It was then compared to the International Prognostic Index and several novel risk scores to determine which approach more accurately predicted outcomes after CAR T-cell treatment.
Metabolic tumor volume was found to be an important predictor of progression-free survival, outperforming the International Prognostic Index commonly used by clinicians. The researchers found that higher metabolic tumor burden was associated with worse outcomes.
"This quantitative measurement has the potential to significantly improve pre-treatment risk stratification for large B-cell lymphoma patients," said Voltin. "Those with high metabolic tumor burden may benefit from personalized bridging strategies to reduce the tumor volume prior to receiving CAR T-cell therapy."
He continued, "Quantitative PET biomarkers such as metabolic tumor volume may further enhance the value of PET for personalized treatment planning, not only in the specific setting of CAR T-cell therapy but also across other treatment regimens and lymphoma subtypes."
The authors of " Risk Assessment in Large B-Cell Lymphoma Using Metabolic Tumor Volume: Real-World Data from a Multicenter Cohort of Patients Undergoing CAR T-Cell Therapy " include Conrad-Amadeus Voltin, Alexander Drzezga, and Markus Dietlein, Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Sarah Flossdorf, Institute for Medical Informatics, Biometry, and Epidemiology, University Hospital Essen, University of Duisburg Essen, Essen, Germany; Lars Kurch, Department of Nuclear Medicine, University Hospital Leipzig, University of Leipzig, Leipzig, Germany, and Department of Anesthesiology and Surgical Intensive Care, University Hospital Halle, Martin Luther University Halle Wittenberg, Halle, Germany; Michael Winkelmann and Wolfgang G. Kunz, Department of Radiology, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany; Andrea Farolfi, Division of Nuclear Medicine, Scientific Institute for Research, Hospitalization, and Healthcare Azienda Ospedaliero Universitaria di Bologna , University of Bologna, Bologna, Italy; Laura Beckmann, Nadine Kutsch, Peter Borchmann, Jan-Michel Heger, and Philipp G del, Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Beatrice Casadei, L. e A. Ser gnoli Institute of Hematology, Scientific Institute for Research, Hospitalization, and Healthcare Azienda Ospedaliero Universitaria di Bologna , University of Bologna, Bologna, Italy; Ken Herrmann, Department of Nuclear Medicine, University Hospital Essen, University of Duisburg Essen, Essen, Germany; Matthias Brendel and Gabriel T. Sheikh, Department of Nuclear Medicine, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany; Viktoria Blumenberg and Marion Subklewe, Department of Medicine III, University Hospital Munich, Ludwig Maximilian University Munich, Munich, Germany and Laboratory for Translational Cancer Immunology, Gene Center Munich, Ludwig Maximilian University Munich, Munich, Germany; Stefano Fanti, Division of Nuclear Medicine, Scientific Institute for Research, Hospitalization, and Healthcare Azienda Ospedaliero Universitaria di Bologna , University of Bologna, Bologna, Italy, and Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Pier Luigi Zinzani, L. e A. Ser gnoli Institute of Hematology, Scientific Institute for Research, Hospitalization, and Healthcare Azienda Ospedaliero Universitaria di Bologna , University of Bologna, Bologna, Italy, and Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Kambiz Rahbar, Department of Nuclear Medicine, University Hospital M nster, University of M nster, M nster, Germany; Osama Sabri, Department of Nuclear Medicine, University Hospital Leipzig, University of Leipzig, Leipzig, Germany; H. Christian Reinhardt, Bastian von Tresckow, and Christine Hanoun, Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University of Duisburg Essen, Essen, Germany; J rn C. Albring, Department of Medicine A Hematology, Oncology, and Pneumology, University Hospital M nster, University of M nster, M nster, Germany; Robert Seifert, Department of Nuclear Medicine, University Hospital Essen, University of Duisburg Essen, Essen, Germany, Department of Nuclear Medicine, University Hospital M nster, University of M nster, M nster, Germany, and Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Andrea Paccagnella, Nuclear Medicine Service, M. Bufalini Hospital, Azienda Unit Sanitaria Locale Romagna, Cesena, Italy; and Vladan Vučinić, Department of Hematology, Cellular Therapy, Hemostaseology, and Infectious Diseases, University Hospital Leipzig, University of Leipzig, Leipzig, Germany, and Department of Cell and Gene Therapy Development, Fraunhofer Institute for Cell Therapy and Immunology, Leipzig, Germany.
Visit the JNM website for the latest research, and follow our new Twitter and Facebook pages @JournalofNucMed or follow us on LinkedIn .
###
Please visit the SNMMI Media Center for more information about molecular imaging and precision imaging. To schedule an interview with the researchers, please contact Rebecca Maxey at (703) 652-6772 or rmaxey@snmmi.org .
About JNM and the Society of Nuclear Medicine and Molecular Imaging
The Journal of Nuclear Medicine (JNM) is the world s leading nuclear medicine, molecular imaging and theranostics journal, accessed 15 million times each year by practitioners around the globe, providing them with the information they need to advance this rapidly expanding field. Current and past issues of The Journal of Nuclear Medicine can be found online at http://jnm.snmjournals.org.
JNM is published by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), an international scientific and medical organization dedicated to advancing nuclear medicine, molecular imaging, and theranostics precision medicine that allows diagnosis and treatment to be tailored to individual patients in order to achieve the best possible outcomes. For more information, visit www.snmmi.org.
Journal of Nuclear Medicine
Risk Assessment in Large B-Cell Lymphoma Using Metabolic Tumor Volume: Real-World Data from a Multicenter Cohort of Patients Undergoing CAR T-Cell Therapy