预测弥漫大 B 细胞淋巴瘤患者复发的 FDG PET/CT 最大肿瘤扩散情况

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Nuclear Medicine and Molecular Imaging Pub Date : 2023-02-01 Epub Date: 2022-10-27 DOI:10.1007/s13139-022-00782-2
Joon-Hyung Jo, Hyun Woo Chung, Sung-Yong Kim, Mark Hong Lee, Young So
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引用次数: 0

摘要

目的:我们研究了弥漫大B细胞淋巴瘤(DLBCL)患者的最大肿瘤播散(Dmax)的预后价值,即通过氟-18脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG PET/CT)评估的恶性病灶之间相距最远的距离,以及其他临床因素。我们研究了弥漫大B细胞淋巴瘤(DLBCL)患者最大肿瘤扩散(Dmax)的预后价值(Dmax是通过氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(FDG PET/CT)评估的恶性病灶之间最远的距离)以及其他临床因素:方法:对接受 FDG PET/CT 对弥漫性大 B 细胞淋巴瘤进行初始分期和治疗反应评估的患者进行回顾性研究。测量基线Dmax、最大标准化摄取值、所有代谢肿瘤体积总和(tMTV)和所有病变糖酵解总和(tTLG)。在一线治疗的中期和末期(EOT),使用多维尔评分(DS)评估治疗反应。分析了FDG PET/CT参数和其他临床因素,包括性别、年龄、血清乳酸脱氢酶(LDH)水平、分期、表现状态和国际预后指数(IPI),以确定预示疾病进展时间(TTP)和疾病特异性生存期(DSS)的因素:结果:共纳入63名患者。单变量生存分析发现,Dmax(> 275 mm)、tMTV(> 180 mL)、tTLG(> 1300)、中期 DS(≥ 4)和 EOT DS(≥ 4)是不良 TTP 的重要预测因素。血清 LDH 水平(> 640 IU/L)、IPI(≥ 4)、tMTV(> 180 mL)、tTLG(> 1300)、中期 DS(≥ 4)和 EOT DS(≥ 4)是 DSS 的重要预测指标。经过多变量生存分析,Dmax(P = 0.008)和EOT DS(P = 0.005)是TTP的独立预测因子。EOT DS是DSS的独立预测因子(P = 0.029):结论:诊断时的Dmax和FDG PET/CT评估的EOT反应为DLBCL患者提供了与IPI相加的有用预后信息。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
FDG PET/CT Maximum Tumor Dissemination to Predict Recurrence in Patients with Diffuse Large B-Cell Lymphoma.

Purpose: We investigated the prognostic value of maximum tumor dissemination (Dmax), the distance between malignant lesions that were farthest apart, as assessed by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), and other clinical factors in patients with diffuse large B-cell lymphoma (DLBCL).We investigated the prognostic value of maximum tumor dissemination (Dmax), the distance between malignant lesions that were farthest apart, as assessed by fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT), and other clinical factors in patients with diffuse large B-cell lymphoma (DLBCL).

Methods: Patients who underwent FDG PET/CT for initial staging and treatment response evaluation of DLBCL were reviewed retrospectively. Baseline Dmax, maximum standardized uptake value, total summation of all metabolic tumor volumes (tMTV), and total summation of all total lesion glycolysis (tTLG) were measured. The treatment response was evaluated at the interim and end of first-line treatment (EOT) using the Deauville score (DS). FDG PET/CT parameters and other clinical factors including sex, age, serum lactate dehydrogenase (LDH) level, stage, performance status, and the International Prognostic Index (IPI) were analyzed to identify factors prognostic of the time to progression (TTP) and disease-specific survival (DSS).

Results: A total of 63 patients were included. Univariate survival analysis identified Dmax (> 275 mm), tMTV (> 180 mL), tTLG (> 1300), interim DS (≥ 4), and EOT DS (≥ 4) as significant predictors of poor TTP. Serum LDH level (> 640 IU/L), IPI (≥ 4), tMTV (> 180 mL), tTLG (> 1300), interim DS (≥ 4), and EOT DS (≥ 4) were significant predictors of DSS. After multivariate survival analysis, Dmax (P = 0.008) and EOT DS (P = 0.005) were independent predictors of TTP. EOT DS was an independent predictor of DSS (P = 0.029).

Conclusions: Dmax at the time of diagnosis and the EOT response assessed by FDG PET/CT provide useful prognostic information additive to the IPI in patients with DLBCL.

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来源期刊
Nuclear Medicine and Molecular Imaging
Nuclear Medicine and Molecular Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
2.20
自引率
7.70%
发文量
58
期刊介绍: Nuclear Medicine and Molecular Imaging (Nucl Med Mol Imaging) is an official journal of the Korean Society of Nuclear Medicine, which bimonthly publishes papers on February, April, June, August, October, and December about nuclear medicine and related sciences such as radiochemistry, radiopharmacy, dosimetry and pharmacokinetics / pharmacodynamics of radiopharmaceuticals, nuclear and molecular imaging analysis, nuclear and molecular imaging instrumentation, radiation biology and radionuclide therapy. The journal specially welcomes works of artificial intelligence applied to nuclear medicine. The journal will also welcome original works relating to molecular imaging research such as the development of molecular imaging probes, reporter imaging assays, imaging cell trafficking, imaging endo(exo)genous gene expression, and imaging signal transduction. Nucl Med Mol Imaging publishes the following types of papers: original articles, reviews, case reports, editorials, interesting images, and letters to the editor. The Korean Society of Nuclear Medicine (KSNM) KSNM is a scientific and professional organization founded in 1961 and a member of the Korean Academy of Medical Sciences of the Korean Medical Association which was established by The Medical Services Law. The aims of KSNM are the promotion of nuclear medicine and cooperation of each member. The business of KSNM includes holding academic meetings and symposia, the publication of journals and books, planning and research of promoting science and health, and training and qualification of nuclear medicine specialists.
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