Karam Maroun, Ata Ashar, Irish Kevin, Feustel Paul J, Mottaghy Felix M, Stroobants Sigrid G, Verhoef Gregor E, Chundru Surya, Douglas-Nikitin Vonda, Oliver Wong Ching-yee, Brepoels Lieselot M
Department of Radiology, Albany Medical College, Albany, New York 12208, USA.
Nucl Med Commun. 2009 Oct;30(10):770-8. doi: 10.1097/MNM.0b013e32832e0c13.
Patients diagnosed with mantle cell lymphoma (MCL) have generally poor prognosis, but a minority have a longer survival. There are no markers to identify this group and no generally established prognostic index for MCL. Our objective was to assess the prognostic value of the staging FDG PET/computed tomography (CT) scan.
We retrospectively analyzed initial scans performed at three institutions on biopsy-proven, cyclin D (+) MCL patients. The association of the SUVmax of the 'hottest focus' with overall survival (OS) and failure-free survival (FFS) was evaluated. Receiver operating characteristic analysis of SUVmax versus survival was used to establish a cut-off point of 4.83. In addition, PET findings were compared with contrast-enhanced CT performed within 3 weeks in patients from one institution.
Both the OS and FFS for patients with SUVmax greater than 5 were significantly decreased (P<0.01 and <0.001, respectively) as compared with the patients with SUV < or = 5. The 5-year OS for group with SUVmax < or = 5 was 87.7% and for SUVmax greater than 5 it was 34%. For SUVmax < or = 5, the median FFS was 45.3 months as compared with 10.6 months for SUVmax greater than 5. PET changed the stage as compared with CT alone in 45% of patients.
Staging FDG PET/CT is superior to CT and may be used in the future for identification of a subset of MCL patients with a better outcome than otherwise expected.
被诊断为套细胞淋巴瘤（MCL）的患者总体预后通常较差，但少数患者生存期较长。目前尚无标志物可识别这一群体，也没有普遍确立的MCL预后指数。我们的目的是评估分期氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）的预后价值。
我们回顾性分析了在三个机构对经活检证实的细胞周期蛋白D（+）MCL患者进行的初始扫描。评估了“最热点”的最大标准摄取值（SUVmax）与总生存期（OS）和无失败生存期（FFS）的相关性。采用SUVmax与生存期的受试者工作特征分析来确定截断点为4.83。此外，还将来自一个机构的患者的PET结果与在3周内进行的增强CT结果进行了比较。
与SUV≤5的患者相比，SUVmax大于5的患者的OS和FFS均显著降低（分别为P<0.01和<0.001）。SUVmax≤5组的5年OS为87.7%，而SUVmax大于5组为34%。对于SUVmax≤5，中位FFS为45.3个月，而SUVmax大于5组为10.6个月。与单纯CT相比，PET使45%的患者分期发生了改变。
分期FDG PET/CT优于CT，未来可能用于识别一部分预后比预期更好的MCL患者。
