The prognostic value of metabolic heterogeneity parameter coefficient of variation (COV) of baseline 18F-FDG PET/CT in newly diagnosed diffuse large B-cell lymphoma

Metabolic heterogeneity parameter COV was a strong independent prognostic factor in DLBCL patients. Based on pathological BM involvement, TMTV and COV, two predictive models were established and their performance was evaluated for predicting PFS and OS. The risk stratification combining COV and ¹⁸F-FDG uptake in BM involvement also had significant prognosis value in PFS and OS. Our exploratory study revealed that metabolic heterogeneity parameters measured via ¹⁸F-FDG PET/CT can preliminarily distinguish DLBCL patients most responsive to standard R-CHOP or analogous chemotherapy regimens, providing a preliminary basis for prognostic stratification in this cohort.