ArticleEuropean journal of nuclear medicine and molecular imaging2026
Prognostic value of TMTV and Dmax calculated from
Article in European journal of nuclear medicine and molecular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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13 authors.
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Abstract
purposeCutaneous melanoma (CM) is an aggressive malignancy with rising incidence. Immune checkpoint blockades (ICBs), particularly anti-PD-1 therapies, have improved survival in metastatic CM. However, many patients show primary resistance or develop progression after initial benefit. Early identification of patients likely to benefit remains a clinical challenge. Total Metabolic Tumor Volume (TMTV) and the maximum distance between two lesions (Dmax), derived from baseline [18F]FDG-PET/CT, have shown prognostic relevance in other cancers. This study evaluates their prognostic value in metastatic CM.
methodsThis retrospective study included 143 patients with metastatic CM treated with ICBs (2016-2023) across two centers. Tumor lesions were segmented using PERCIST procedure on baseline (PET0) and early follow-up (PET1, 9-12 weeks post-treatment) [18F]FDG-PET/CT. TMTV, Dmax, and their changes (ΔTMTV, ΔDmax) were calculated. Associations with progression-free survival (PFS) and overall survival (OS) were assessed, including in multivariable analyses.
resultsElevated Dmax (above median) at PET0 was independently linked to poorer PFS (HR = 1.67; 95% confidence interval (CI): 1.03-2.71; p = 0.036) and OS (HR = 2.03; 95% CI: 1.20-3.43; p = 0.009). Stable or increased TMTV and Dmax between PET0 and PET1 (ΔTMTV and ΔDmax ≥ 0%) correlated with significantly worse outcomes. Using PET0 TMTV and Dmax, as well as ΔTMTV and ΔDmax considered separately, allowed stratification into three risk groups with distinct prognoses.
conclusionBaseline TMTV and Dmax, along with their early changes, are strong prognostic markers in metastatic CM treated with ICBs. Their integration into clinical practice may enhance early risk stratification and inform personalized therapeutic strategies.
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