{"title":"18F-FDG PET/CT预测嵌合抗原受体T细胞治疗b细胞非霍奇金淋巴瘤患者的预后：输注前和M1图像的价值","authors":"Xilan Yao, Hongrong Wang, Xiao Lei, Jialing Cui, Shuang Yao, Jigang Yang","doi":"10.1007/s00259-025-07302-2","DOIUrl":null,"url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>We aimed to evaluate the prognostic value of pre- and post-infusion <sup>18</sup>F-FDG PET/CT for B-cell non-Hodgkin lymphoma B-NHL) patients treated with anti-CD19 chimeric antigen receptor T (CAR-T) cells.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>B-NHL patients who received CAR-T therapy and underwent <sup>18</sup>F-FDG PET/CT examination one month before (pre-infusion) and after (M1) CAR-T infusion were collected and regularly followed up. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) was recorded for each PET/CT performed, as well as some clinical and laboratory indexes. Progression-free survival (PFS) and overall survival (OS) were endpoints, estimated by the Kaplan-Meier method.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Ninety-three patients were included. The median follow-up time was 21.1 months. Multivariate analysis showed that extranodal (EN) sites and SUVmax at M1 were independent prognostic factors for PFS. Patients with EN sites ≥ 2 had shorter median PFS than those with EN sites < 2 (6.4 months vs. not reached [NR], <i>P</i> = 0.032). Patients with M1 SUVmax ≥ 12.4 had shorter median PFS than those with SUVmax < 12.4 (1.1 months vs. NR, <i>P</i> < 0.001). Regarding OS, International Prognostic Index (IPI) and SUVmax at M1 were strongly associated with subsequent outcomes. The median OS was 14.1 months for patients with IPI ≥ 3, compared with NR for those with IPI < 3 (<i>P</i> = 0.011). Patients with SUVmax < 12.9 at M1 had longer median OS compared to those with SUVmax ≥ 12.9 (NR vs. 12.0 months, <i>P</i> < 0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>For B-NHL patients who received CAR-T therapy, M1 PET/CT had a more important prognostic value than the pre-infusion one. EN sites and SUVmax at M1 were independent risk factors for PFS, and IPI and SUVmax at M1 for OS. Integrating the clinical characteristics and PET/CT parameters can be helpful for early decision-making in patient management.</p><h3 data-test=\"abstract-sub-heading\">Clinical trial number</h3><p>Not applicable.</p>","PeriodicalId":11909,"journal":{"name":"European Journal of Nuclear Medicine and Molecular Imaging","volume":"44 1","pages":""},"PeriodicalIF":8.6000,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"18F-FDG PET/CT for predicting prognosis of B-cell non-Hodgkin lymphoma patients treated with chimeric antigen receptor T cells: the value of pre-infusion and M1 image\",\"authors\":\"Xilan Yao, Hongrong Wang, Xiao Lei, Jialing Cui, Shuang Yao, Jigang Yang\",\"doi\":\"10.1007/s00259-025-07302-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<h3 data-test=\\\"abstract-sub-heading\\\">Purpose</h3><p>We aimed to evaluate the prognostic value of pre- and post-infusion <sup>18</sup>F-FDG PET/CT for B-cell non-Hodgkin lymphoma B-NHL) patients treated with anti-CD19 chimeric antigen receptor T (CAR-T) cells.</p><h3 data-test=\\\"abstract-sub-heading\\\">Methods</h3><p>B-NHL patients who received CAR-T therapy and underwent <sup>18</sup>F-FDG PET/CT examination one month before (pre-infusion) and after (M1) CAR-T infusion were collected and regularly followed up. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) was recorded for each PET/CT performed, as well as some clinical and laboratory indexes. Progression-free survival (PFS) and overall survival (OS) were endpoints, estimated by the Kaplan-Meier method.</p><h3 data-test=\\\"abstract-sub-heading\\\">Results</h3><p>Ninety-three patients were included. The median follow-up time was 21.1 months. Multivariate analysis showed that extranodal (EN) sites and SUVmax at M1 were independent prognostic factors for PFS. Patients with EN sites ≥ 2 had shorter median PFS than those with EN sites < 2 (6.4 months vs. not reached [NR], <i>P</i> = 0.032). Patients with M1 SUVmax ≥ 12.4 had shorter median PFS than those with SUVmax < 12.4 (1.1 months vs. NR, <i>P</i> < 0.001). Regarding OS, International Prognostic Index (IPI) and SUVmax at M1 were strongly associated with subsequent outcomes. The median OS was 14.1 months for patients with IPI ≥ 3, compared with NR for those with IPI < 3 (<i>P</i> = 0.011). Patients with SUVmax < 12.9 at M1 had longer median OS compared to those with SUVmax ≥ 12.9 (NR vs. 12.0 months, <i>P</i> < 0.001).</p><h3 data-test=\\\"abstract-sub-heading\\\">Conclusion</h3><p>For B-NHL patients who received CAR-T therapy, M1 PET/CT had a more important prognostic value than the pre-infusion one. EN sites and SUVmax at M1 were independent risk factors for PFS, and IPI and SUVmax at M1 for OS. Integrating the clinical characteristics and PET/CT parameters can be helpful for early decision-making in patient management.</p><h3 data-test=\\\"abstract-sub-heading\\\">Clinical trial number</h3><p>Not applicable.</p>\",\"PeriodicalId\":11909,\"journal\":{\"name\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"volume\":\"44 1\",\"pages\":\"\"},\"PeriodicalIF\":8.6000,\"publicationDate\":\"2025-05-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Nuclear Medicine and Molecular Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00259-025-07302-2\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Nuclear Medicine and Molecular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00259-025-07302-2","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 0
摘要
目的探讨18F-FDG PET/CT输注前后对抗cd19嵌合抗原受体T （CAR-T）细胞治疗的b细胞非霍奇金淋巴瘤（B-NHL）患者的预后价值。方法收集CAR-T治疗前后1个月行18F-FDG PET/CT检查的sb - nhl患者，定期随访。记录每台PET/CT的最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）、病变总糖酵解（TLG）以及一些临床和实验室指标。无进展生存期（PFS）和总生存期（OS）是终点，通过Kaplan-Meier方法估计。结果纳入93例患者。中位随访时间为21.1个月。多因素分析显示结外（EN）部位和M1处的SUVmax是PFS的独立预后因素。EN位点≥2的患者的中位PFS短于EN位点≥2的患者（6.4个月vs.未达到[NR]， P = 0.032）。M1 SUVmax≥12.4的患者比SUVmax <； 12.4的患者有更短的中位PFS（1.1个月vs NR， P < 0.001）。关于OS，国际预后指数（IPI）和M1时的SUVmax与后续结果密切相关。IPI≥3的患者中位OS为14.1个月，而IPI≥3的患者中位OS为NR （P = 0.011）。M1时SUVmax <； 12.9的患者比SUVmax≥12.9的患者有更长的中位生存期（NR vs. 12.0个月，P < 0.001）。结论对于接受CAR-T治疗的B-NHL患者，M1 PET/CT比输注前具有更重要的预后价值。EN位点和M1处的SUVmax是PFS的独立危险因素，IPI和M1处的SUVmax是OS的独立危险因素。将临床特征与PET/CT参数相结合，有助于患者管理的早期决策。临床试验编号不适用。
18F-FDG PET/CT for predicting prognosis of B-cell non-Hodgkin lymphoma patients treated with chimeric antigen receptor T cells: the value of pre-infusion and M1 image
Purpose
We aimed to evaluate the prognostic value of pre- and post-infusion 18F-FDG PET/CT for B-cell non-Hodgkin lymphoma B-NHL) patients treated with anti-CD19 chimeric antigen receptor T (CAR-T) cells.
Methods
B-NHL patients who received CAR-T therapy and underwent 18F-FDG PET/CT examination one month before (pre-infusion) and after (M1) CAR-T infusion were collected and regularly followed up. Maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG) was recorded for each PET/CT performed, as well as some clinical and laboratory indexes. Progression-free survival (PFS) and overall survival (OS) were endpoints, estimated by the Kaplan-Meier method.
Results
Ninety-three patients were included. The median follow-up time was 21.1 months. Multivariate analysis showed that extranodal (EN) sites and SUVmax at M1 were independent prognostic factors for PFS. Patients with EN sites ≥ 2 had shorter median PFS than those with EN sites < 2 (6.4 months vs. not reached [NR], P = 0.032). Patients with M1 SUVmax ≥ 12.4 had shorter median PFS than those with SUVmax < 12.4 (1.1 months vs. NR, P < 0.001). Regarding OS, International Prognostic Index (IPI) and SUVmax at M1 were strongly associated with subsequent outcomes. The median OS was 14.1 months for patients with IPI ≥ 3, compared with NR for those with IPI < 3 (P = 0.011). Patients with SUVmax < 12.9 at M1 had longer median OS compared to those with SUVmax ≥ 12.9 (NR vs. 12.0 months, P < 0.001).
Conclusion
For B-NHL patients who received CAR-T therapy, M1 PET/CT had a more important prognostic value than the pre-infusion one. EN sites and SUVmax at M1 were independent risk factors for PFS, and IPI and SUVmax at M1 for OS. Integrating the clinical characteristics and PET/CT parameters can be helpful for early decision-making in patient management.
期刊介绍：
The European Journal of Nuclear Medicine and Molecular Imaging serves as a platform for the exchange of clinical and scientific information within nuclear medicine and related professions. It welcomes international submissions from professionals involved in the functional, metabolic, and molecular investigation of diseases. The journal's coverage spans physics, dosimetry, radiation biology, radiochemistry, and pharmacy, providing high-quality peer review by experts in the field. Known for highly cited and downloaded articles, it ensures global visibility for research work and is part of the EJNMMI journal family.
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