Cortés Romera M, Gámez Cenzano C, Caresia Aróztegui A P, Martín-Comín J, González-Barca E, Ricart Brulles Y, Palacios Abufón A, Robles Barba J, Rodríguez-Bel L, Rossi Seoane S, Fernández de Sevilla A
Unitat PET, Institut de Diagnòstic per la Imatge (IDI), Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
Rev Esp Med Nucl Imagen Mol. 2012 May-Jun;31(3):135-41. doi: 10.1016/j.remn.2011.05.011. Epub 2011 Sep 23.
To assess the role of FDG-PET/CT performed after the first cycles of chemotherapy in the prediction of response to treatment in patients with diffuse large B-cell lymphoma.
Twenty patients (mean age: 48 years) were included, 16 initial staging and 4 relapse. All patients underwent PET/CT at 3 times: 1) Baseline, 2) After 1-3 cycles of chemotherapy (early response assessment), and 3) End of treatment (evaluation of final response). Early PET/CT findings were correlated to the end-treatment PET/CT and follow-up. The evaluation of the response was established according to the decrease in uptake of the lesions (SUVmax). In the early assessment, a good response indicator (GRI) was obtained when the lesion disappeared or had more than 50% reduction in SUVmax. At the end of the treatment, a complete metabolic response (CMR) was determined in negative PET scans. Follow-up was superior to 19 months and final outcome was established as progression/relapse or no evidence of disease (NED).
At the early treatment evaluation, 16/16 patients of initial staging (100%) and 2/4 of relapse (50%) achieved GRI. At the end of treatment evaluation, 14/16 patients of initial staging with GRI achieved CMR and 1/16 PMR: 14 were alive with NED in the follow-up while 1 relapsed. In the second group, 2/2 patients with GRI achieved CMR (100%): 1 continued with NED in the follow-up and another relapsed.
FDG-PET/CT after the first cycles of chemotherapy is useful to monitor treatment due to its high negative predictive value (87.5%), using it to modify treatment early in the non-responders.
评估在弥漫性大B细胞淋巴瘤患者化疗的首个周期后进行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）在预测治疗反应中的作用。
纳入20例患者（平均年龄：48岁），其中16例为初始分期，4例为复发患者。所有患者均接受3次PET/CT检查：1）基线期；2）化疗1 - 3个周期后（早期反应评估）；3）治疗结束时（最终反应评估）。早期PET/CT检查结果与治疗结束时的PET/CT及随访情况相关。根据病变摄取减少情况（最大标准化摄取值，SUVmax）评估反应。在早期评估中，当病变消失或SUVmax降低超过50%时，获得良好反应指标（GRI）。治疗结束时，PET扫描阴性则判定为完全代谢缓解（CMR）。随访时间超过19个月，最终结局判定为进展/复发或无疾病证据（NED）。
在早期治疗评估中，16例初始分期患者中的16例（100%）和4例复发患者中的2例（50%）达到GRI。在治疗结束评估时，16例初始分期且达到GRI的患者中，14例达到CMR，1例达到部分代谢缓解（PMR）：随访中14例存活且无疾病证据，1例复发。在第二组中，2例达到GRI的患者均达到CMR（100%）：随访中1例持续无疾病证据，另1例复发。
化疗首个周期后的FDG-PET/CT因其较高的阴性预测价值（87.5%），有助于监测治疗，可用于在无反应者中早期调整治疗方案。
