Institute of Nuclear Medicine with PET-Centre, Wilhelminenspital, Montleartstrasse 37, 1171, Vienna, Austria.
Med Oncol. 2011 Dec;28(4):1570-6. doi: 10.1007/s12032-010-9584-2. Epub 2010 Jun 4.
Metabolic imaging with F-18-fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET) is widely used for staging and treatment evaluation of malignant lymphoma. To date, only a few studies have indicated that lower glucose metabolism measured by 18F-FDG PET before or early in the course of treatment of malignant lymphoma is associated with a favorable outcome. The aim of this study was to assess the prognostic capability of the 18F-FDG PET maximum standardized uptake value (SUVmax), a semiquantitative measurement of glucose metabolism, at the time of diagnosis of malignant lymphoma. We retrospectively analyzed data from 69 patients (median age: 61 and range 23-80) with malignant lymphoma (22 patients with Hodgkin's disease [HD] and 47 patients with Non-Hodgkin's lymphoma [NHL]) who had not received treatment before 18F-FDG PET imaging. Metabolic remission according to PET results was observed after chemotherapy in 50 patients (72.5%), while progressive disease or relapse was diagnosed in 19 patients (27.5%). Clinical follow-up revealed relapse in 4/50 patients with prior metabolic remission. A significantly lower (P<0.01) baseline SUVmax level (median: 4.6 and range 1.5-12.9) was found in patients with subsequent metabolic and clinical response than in those with progressive or relapsing disease (median SUVmax 10.4, range 2.0-17.9). Thirty-seven of thirty-nine patients with baseline SUVmax<7.4 achieved long-lasting remission after completion of chemotherapy (median follow-up: 28 months, range 4-112 months). Within this group with favorable outcome, there were no significant differences between SUVmax values in HD and NHL. A heterogeneous outcome was noted in 25 patients with a SUVmax≥7.4 and ≤12.9 at diagnosis, with 16 patients experiencing disease progression or relapse and nine patients extended remission. The five patients with SUVmax>12.9 showed disease progression at follow-up. Semiquantitative measurement of glucose metabolism (SUVmax) by 18F-FDG PET at diagnosis is a predictor of outcome of patients with malignant lymphoma.
正电子发射断层扫描（PET）用 F-18-氟脱氧葡萄糖（18F-FDG）代谢成像广泛用于恶性淋巴瘤的分期和治疗评估。迄今为止，只有少数研究表明，恶性淋巴瘤治疗前或早期测量的 18F-FDG PET 葡萄糖代谢较低与预后良好相关。本研究旨在评估恶性淋巴瘤诊断时 18F-FDG PET 最大标准化摄取值（SUVmax）的预后能力，这是葡萄糖代谢的半定量测量。我们回顾性分析了 69 名未接受治疗的恶性淋巴瘤患者（中位年龄：61 岁，范围 23-80 岁）的资料，其中 22 名霍奇金病（HD）患者和 47 名非霍奇金淋巴瘤（NHL）患者。50 名患者（72.5%）在化疗后达到了根据 PET 结果的代谢缓解，而 19 名患者（27.5%）被诊断为进展或复发。临床随访显示，先前代谢缓解的 4/50 名患者复发。随后代谢和临床反应的患者基线 SUVmax 水平显著较低（P<0.01）（中位数：4.6，范围 1.5-12.9），而进展或复发疾病的患者（中位数 SUVmax 10.4，范围 2.0-17.9）。39 名基线 SUVmax<7.4 的患者在完成化疗后获得了持久缓解（中位随访：28 个月，范围 4-112 个月）。在这一预后良好的组中，HD 和 NHL 之间的 SUVmax 值没有显著差异。25 名基线 SUVmax 值为 7.4-12.9 的患者的结果不同，其中 16 名患者病情进展或复发，9 名患者延长缓解。5 名 SUVmax>12.9 的患者在随访中病情进展。恶性淋巴瘤患者诊断时的 18F-FDG PET 葡萄糖代谢的半定量测量（SUVmax）是预后的预测因子。
