• Clario accelerates your clinical trial from initiation to implementation. LEARN MORE →

Your using an unsupported browser. Please update to a modern browser for a better experience.
Skip to content
Clario Clario
  • Solutions
    • eCOA Clinical Trials
      • eCOA Clinical Trials
      • eCOA Live
      • eCOA Multimedia
      • eCOA Rater and Participant Training
      • eCOA Rescue Studies
      • Suicidal Ideation
    • Artificial Intelligence (AI)

      Discover Clario's AI solutions, where innovation meets expertise. Since 2018, we have revolutionized clinical trial endpoint analyses with more than 30 AI-enabled solutions across 600+ active trials, enhancing data quality and patient privacy while expediting data collection processes.

      Go to page
    • Cardiac Safety
      • Cardiac Safety
      • Arrhythmia Analysis
      • Blood Pressure Services
      • ECG — On-site to DCT and Phase I-IV
      • Phase I/TQT Cardiac Assessment
      • Regulatory Consultation and Statistical Analysis Expertise
    • Medical Imaging
      • Medical Imaging
      • Medical Imaging science team
      • Image Redact AI
      • Image Repository
      • Imaging Platform
      • Image Workflow
      • Modalities
      • SMART Submit
    • Precision Motion for Clinical Trials
      • Precision Motion for Clinical Trials
      • Precision Motion: Scientific Consulting Services
      • Precision Motion: Scientific Publications
    • Respiratory Solutions
      • Respiratory Solutions
      • Site-Based Spirometry (FEV1, FVC, PEF, etc.)
      • Home & Hybrid DCT Spirometry​
      • Cough and Lung Sounds
      • Diffusing Capacity (DLCO)
    • Trial Enablement
      • Trial Enablement
      • Clinical Adjudication
      • Eligibility Solution
      • Reporting & Analytics
      • Source Document Manager
    • Decentralized Trials

      All the precision endpoint technology and services your virtual or hybrid trial needs to deliver more certain outcomes.

      Go to page
  • Therapeutic Areas
    • Cardiovascular & Metabolic
    • Dermatology
    • Gastroenterology
    • Hepatology
    • Infectious Diseases
    • Musculoskeletal
    • Neuroscience
    • Oncology Clinical Trials
    • Ophthalmology
    • Respiratory Solutions
  • Resources
    • Articles
    • Case Studies
    • Downloads
    • Events
    • External Publications
    • Webinars
  • About
    • The Clario Story
    • Careers
    • Corporate & Social Responsibility
    • Leadership
    • Legal & Privacy
    • Newsroom
    • Scientific Expertise
    • Security Governance
    • Strategic Partnerships
    • Values & Culture
  • Support
    • Customer Support
    • In-Country Cardiac Safety Support
  • Solutions
    • eCOA Clinical Trials
      • eCOA Clinical Trials
      • eCOA Live
      • eCOA Multimedia
      • eCOA Rater and Participant Training
      • eCOA Rescue Studies
      • Suicidal Ideation
    • Artificial Intelligence (AI)
    • Cardiac Safety
      • Cardiac Safety
      • Arrhythmia Analysis
      • Blood Pressure Services
      • ECG — On-site to DCT and Phase I-IV
      • Phase I/TQT Cardiac Assessment
      • Regulatory Consultation and Statistical Analysis Expertise
    • Medical Imaging
      • Medical Imaging
      • Medical Imaging science team
      • Image Redact AI
      • Image Repository
      • Imaging Platform
      • Image Workflow
      • Modalities
      • SMART Submit
    • Precision Motion for Clinical Trials
      • Precision Motion for Clinical Trials
      • Precision Motion: Scientific Consulting Services
      • Precision Motion: Scientific Publications
    • Respiratory Solutions
      • Respiratory Solutions
      • Site-Based Spirometry (FEV1, FVC, PEF, etc.)
      • Home & Hybrid DCT Spirometry​
      • Cough and Lung Sounds
      • Diffusing Capacity (DLCO)
    • Trial Enablement
      • Trial Enablement
      • Clinical Adjudication
      • Eligibility Solution
      • Reporting & Analytics
      • Source Document Manager
    • Decentralized Trials
      • Decentralized Trials
  • Therapeutic Areas
    • Cardiovascular & Metabolic
    • Dermatology
    • Gastroenterology
    • Hepatology
    • Infectious Diseases
    • Musculoskeletal
    • Neuroscience
    • Oncology Clinical Trials
    • Ophthalmology
    • Respiratory Solutions
  • Resources
    • Articles
    • Case Studies
    • Downloads
    • Events
    • External Publications
    • Webinars
  • About
    • The Clario Story
    • Corporate & Social Responsibility
    • Leadership
    • Legal & Privacy
    • Scientific Expertise
    • Security Governance
    • Strategic Partnerships
    • Values & Culture
  • Support
    • Customer Support
    • In-Country Cardiac Safety Support
  • Careers
    • Life at Clario
  • Newsroom
  • Login
  • Contact sales
    • Log in
    • Contact sales
  1. Home Resources Articles Total metabolic tumor volume — A valuable new method of assessment of global response to therapy

Total metabolic tumor volume — A valuable new method of assessment of global response to therapy

This measurement brings useful, independent, and correlative information to the clinical drug evaluation process

John G Wolodzko, Ph.D., DABSNM, FACNM – Sr. Medical Physicist at Clario

Over the past few years, many papers have been published by groups investigating the utility of 18F-fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) for screening and therapy response assessment in various lymphoma subtypes.

Several of these studies have reported the value of total metabolic tumor volume (TMTV) as a negative or positive prognostic indicator, based on a TMTV above or below a predetermined threshold at baseline, or as an indicator of response according to a change in TMTV over a course of treatment. Different approaches have been investigated for segmenting lesions for volume measurement, including the setting of image thresholds at fixed percentages of lesion maximum standard uptake values (SUVmax), e.g., the 41% of SUVmax suggested by the European Association of Nuclear Medicine (EANM); absolute SUV, e.g. SUV>= 4.0 as advised by the PETRA group; or a multiple of a reference value such as 2.5 times the Liver SUVmean. Although more than one group has concluded that the selection of the most sensitive baseline TMTV cutoff for the purpose of prognostic determination appears to be disease-specific, there is consensus that most, if not all, of the approaches to threshold setting have similar prognostic or response results when the selected method is applied consistently. In addition, at least one group of researchers have reported that FDG-PET-based TMTV evaluations are superior to approaches such as measurements of anatomical size or bulk or qualitative PET assessments such as numerical scoring systems in terms of predicting treatment outcomes or demonstrating response to treatment. TMTV measurements can potentially aid in the selection of patients for appropriate therapies or may support the modification of drug doses for maximum effectiveness.

FDG-PET-based TMTV measurement brings useful, independent, and correlative information to the clinical drug evaluation process. Clario can customize the segmentation threshold settings to meet any special requirements based on disease type or sponsor request or provide measurements based on multiple approaches to segmentation for sponsor downstream evaluation if desired. Additional data, such as Total Lesion Glycolysis (TLG), Fragmentation, and Dissemination based on metabolic tumor volume and distribution of lesions can also be provided for prognostic/response evaluation and can be included in the data provided to the sponsor for a comprehensive demonstration of drug efficacy.

Explore further

Deepen your understanding of oncology and the groundbreaking advancements in the field. Let Clario guide you through the latest research, findings, and innovations.

Learn more

Written by

John Wolodzko headshot

John G Wolodzko, Ph.D., DABSNM, FACNM

Sr. Medical Physicist at Clario


References

1Cottereau A.-S., Hapdey S., Chartier L., Modzelewski R., Casasnovas O., Itti E., Tilly H., Vera P., Meignan M., Becker S. Baseline Total Metabolic Tumor Volume Measured with Fixed or Different Adaptive Thresholding Methods Equally Predicts Outcome in Peripheral T Cell Lymphoma. J. Nucl. Med. 2016;58:276–281

2A. S. Cottereau, S. Becker, F. Broussais et al., “Prognostic value of baseline total metabolic tumor volume (TMTV0) measured on FDG-PET/CT in patients with peripheral T-cell lymphoma (PTCL),” Annals of Oncology, vol. 27, no. 4, pp. 719–724, 2016

3Burggraaff CN, Rahman F, Kaßner I, Pieplenbosch S, Barrington SF, Jauw YWS, et al. Optimizing workflows for fast and reliable metabolic tumor volume measurements in diffuse large B cell lymphoma. Mol Imaging Biol. 2020;22:1102–10

Back to articles
Share
Twitter Facebook LinkedIn

Latest articles

See all articles
Article

The New Liver Lexicon

NASH by any other name would still be fatty liver (but going forward call it SLD) 

Read
Article

Leveraging eC-SSRS for Suicide Risk Assessment

Discover how eC-SSRS is redefining suicide risk assessments with unprecedented accuracy and reliability in oncology trials and beyond

Read
Article

Knowledge is Power: 5 Important Questions You Should Ask Your Sales Rep

How to ensure your prospective provider meets the gold standard for operations and data collection in medical imaging, cardiac safety, and eCOA

Read
Clario logo
    • Solutions
    • Therapeutic Areas
    • About
    • Resources
    • Careers
    • Newsroom
  • Get in touch

    • Contact
    • Support
    • Customer portal

Follow us

Twitter LinkedIn Glassdoor
×

Contact sales

If you are looking for a partner to help you generate the richest clinical evidence with the right clinical trial technology, please fill in the form below.


Not what you're looking for?

Please visit our Contact Page for customer support, office locations, or media contacts.

Thanks for your form. Our team will be in touch very soon.

  • © 2023 Clario

    • Legal and Privacy Terms
    • Security Governance
    • Cookie Policy
    • Impressum

Please enter your business email before proceeding to xTalks to complete registration.

×

Please enter your business email so we can connect with you to provide a personalized review.

×