A prognostic index integrating deep learning baseline PET/CT biomarkers and multi-omics profiling in diffuse large B cell lymphoma.
Authors
Affiliations (13)
Affiliations (13)
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; The SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Nuclear Medicine, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Hematology, Lymphoma Research Center, Peking University Third Hospital, Beijing, China.
- Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
- Department of Hematology, West China Hospital, Sichuan University, Sichuan, China.
- Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Pathology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Department of Hematology, West China Hospital, Sichuan University, Sichuan, China; Department of Hematology, West China Hospital, Sichuan University, Sichuan, China; National Facility for Translational Medicine (Sichuan), West China Hospital, Sichuan University, Sichuan, China.
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; Pôle de Recherches Sino-Français en Science du Vivant et Génomique, Laboratory of Molecular Pathology, Shanghai, China.
- Department of Radiology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; The SJTU-Ruijin-UIH Institute for Medical Imaging Technology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; The Global Institute of Future Technology, Shanghai Jiao Tong University, Shanghai, China. Electronic address: [email protected].
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: [email protected].
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; Pôle de Recherches Sino-Français en Science du Vivant et Génomique, Laboratory of Molecular Pathology, Shanghai, China. Electronic address: [email protected].
Abstract
[<sup>18</sup>F]-Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) is essential for disease staging and treatment response evaluation in diffuse large B cell lymphoma (DLBCL). In this study, we analyze <sup>18</sup>F-FDG-PET scans from 1,024 newly diagnosed DLBCL patients, integrating with DNA and RNA sequencing data. Using the nnUNet deep learning framework and training on both AutoPET public and in-house datasets, we identify key baseline biomarkers-including total metabolic tumor volume (TMTV), Max MTV, and the standardized tumor dissemination biomarker-that demonstrate significant prognostic value. Further integrating PET biomarkers with clinical factors and LymphPlex genetic subtypes, we develop high TMTV, elevated lactate dehydrogenase (LDH), and EZB-like MYC+, MCD-like, and TP53<sup>Mut</sup> subtypes as risk factors to form the ClinicalPET LymphPlex model, efficiently distinguishing patient outcomes across different treatments. Notably, high TMTV correlates with an immunosuppressive tumor microenvironment, while elevated LDH is linked to increased metabolic activity and tumor proliferation. Collectively, our findings necessitate multimodal integration to enhance prognostic precision and advance personalized therapy in DLBCL.