Enhancing prognostication and treatment response evaluation in primary CNS lymphoma with 18F-FDG-PET/CT.

IF 16.4 1区医学 Q1 CLINICAL NEUROLOGY

Neuro-oncology Pub Date : 2024-12-05 DOI:10.1093/neuonc/noae146

Minyoung Oh, Hyungwoo Cho, Ji Eun Park, Ho Sung Kim, Heounjeong Go, Chan-Sik Park, Sang-Wook Lee, Sang Woo Song, Young-Hoon Kim, Young Hyun Cho, Seok Ho Hong, Jeong Hoon Kim, Dong Yun Lee, Jin-Sook Ryu, Dok Hyun Yoon, Jae Seung Kim

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引用次数: 0

Abstract

Background: The role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) in the prognostication and response evaluation of primary central nervous system lymphoma (PCNSL) remains inadequately defined.

Methods: We conducted a retrospective analysis of 268 consecutive newly diagnosed patients with PCNSL between 2006 and 2020. Of these patients, 105 and 110 patients were included to evaluate the prognostic value of baseline and post-treatment 18F-FDG-PET/CT scans, respectively. Tumor uptake was considered positive when it exceeded that of the contralateral brain upon visual assessment. Quantitative analysis of baseline 18F-FDG-PET/CT included measurement of the maximal standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG).

Results: The median age of the 268 patients was 62 years (range: 17-85), with 55% being male. The median progression-free survival (PFS) was 24.5 months (95% CI: 19.9-29.1), and the median overall survival (OS) was 34.5 months (95% CI: 22.9-46.1). The average SUVmax was 15.3 ± 5.7 and the mean TMTV and TLG were 12.6 ± 13.9 cm3 and 135.0 ± 152.7 g, respectively. Patients with a baseline TMTV ≥ 17.0 cm3 had significantly shorter OS (12.5 vs 74.0 months, P = .011). Post-treatment metabolic response by 18F-FDG-PET/CT significantly predicted PFS (median: 10.5 vs 46.0 months, P = .001) and OS (median: 21.0 vs 62.0 months, P = .002), whereas anatomic response by contrast-enhanced MRI showed no statistically significant differences in PFS (P = .130) or OS (P = .540).

Conclusion: Baseline TMTV and post-treatment metabolic response, as assessed by 18F-FDG-PET/CT, are significant prognostic factors in patients with PCNSL.

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利用 18F-FDG PET/CT 加强原发性中枢神经系统淋巴瘤的诊断和治疗反应评估

背景：18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG-PET/CT）在原发性中枢神经系统淋巴瘤（PCNSL）的预后和反应评估中的作用仍未充分明确：我们对 2006 年至 2020 年间新确诊的 268 例 PCNSL 患者进行了回顾性分析。在这些患者中，我们分别纳入了105例和110例患者，以评估基线和治疗后18F-FDG-PET/CT扫描的预后价值。经目测评估，肿瘤摄取量超过对侧大脑的摄取量即为阳性。基线18F-FDG-PET/CT的定量分析包括最大标准化摄取值（SUVmax）、总代谢肿瘤体积（TMTV）和总病变糖酵解（TLG）的测量：268名患者的中位年龄为62岁（17-85岁），55%为男性。中位无进展生存期（PFS）为 24.5 个月（95% 置信区间 [CI]，19.9-29.1），中位总生存期（OS）为 34.5 个月（95% 置信区间 [CI]，22.9-46.1）。平均 SUVmax 为 15.3 ± 5.7，平均 TMTV 和 TLG 分别为 12.6 ± 13.9 立方厘米和 135.0 ± 152.7 克。基线TMTV≥17.0 cm3的患者的OS明显较短（12.5个月对74.0个月，P=0.011）。18F-FDG-PET/CT显示的治疗后代谢反应可显著预测PFS（中位数：10.5个月 vs. 46.0个月，p=0.001）和OS（中位数：21.0个月 vs. 62.0个月，p=0.002），而对比增强MRI显示的解剖反应在PFS（p=0.130）或OS（p=0.540）方面无统计学差异：结论：18F-FDG-PET/CT评估的基线TMTV和治疗后代谢反应是PCNSL患者的重要预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuro-oncology 医学-临床神经学

CiteScore

27.20

自引率

6.30%

发文量

1434

审稿时长

3-8 weeks

期刊介绍： Neuro-Oncology, the official journal of the Society for Neuro-Oncology, has been published monthly since January 2010. Affiliated with the Japan Society for Neuro-Oncology and the European Association of Neuro-Oncology, it is a global leader in the field. The journal is committed to swiftly disseminating high-quality information across all areas of neuro-oncology. It features peer-reviewed articles, reviews, symposia on various topics, abstracts from annual meetings, and updates from neuro-oncology societies worldwide.