Hématologie Clinique, Hopital Le Bocage-CHU Dijon, Dijon Cedex, France.
Curr Hematol Malig Rep. 2012 Sep;7(3):193-9. doi: 10.1007/s11899-012-0129-y.
The prognosis value of interim positron emission tomography (PET) remains controversial in diffuse large B-cell lymphoma (DLBCL) patients because of the absence of consensus on criteria able to early identify good and bad responders to treatment. Visual interpretation using the International Harmonization Project (IHP) criteria, primarily established for end of treatment evaluation, was related to a low positive predictive value of treatment failure. The 5-point scale (5PS) that refers the residual uptake to the liver as background tissue was shown to slightly reduce false-positive interim PET interpretations compared to IHP criteria. Semiquantification of fluorodeoxyglucose (FDG) uptake using standardized uptake value (SUV) and assessment of reduction of maximum SUV (SUVmax) between baseline and interim PET drastically improves both the interpretation accuracy and the interobserver reproducibility, and better predicts patient outcome than visual analysis. This latter approach is feasible in a multicenter setting and allows clinicians to design a risk-adapted therapeutic strategy based on early PET response assessment.
在弥漫性大 B 细胞淋巴瘤（DLBCL）患者中，中期正电子发射断层扫描（PET）的预后价值仍然存在争议，因为缺乏能够早期识别对治疗有良好和不良反应的标准的共识。使用国际协调项目（IHP）标准进行的视觉解释主要用于治疗结束时的评估，与治疗失败的阳性预测值较低有关。与 IHP 标准相比，将残留摄取与肝脏作为背景组织进行比较的 5 分制（5PS）略降低了中期 PET 假阳性解释。使用标准化摄取值（SUV）对氟脱氧葡萄糖（FDG）摄取进行半定量分析，并评估基线与中期 PET 之间最大 SUV（SUVmax）的减少，可极大地提高解释的准确性和观察者间的可重复性，并比视觉分析更好地预测患者的预后。后一种方法在多中心环境中是可行的，并允许临床医生根据早期 PET 反应评估设计风险适应的治疗策略。
