18F-FDG PET 是原发性中枢神经系统淋巴瘤的独立预后预测因子。

18F-FDG PET is an independent outcome predictor in primary central nervous system lymphoma.

机构信息

Department of Hematology/Oncology, Freiburg University Medical Center, Freiburg, Germany.

出版信息

J Nucl Med. 2013 Feb;54(2):184-91. doi: 10.2967/jnumed.112.108654. Epub 2012 Dec 18.

DOI:10.2967/jnumed.112.108654

PMID:23249539

Abstract

UNLABELLED

Primary central nervous system (CNS) lymphoma is an aggressive non-Hodgkin lymphoma with poor prognosis. We evaluated pretreatment (18)F-FDG PET as a prognostic marker in primary CNS lymphoma.

METHODS

Forty-two immunocompetent patients with newly diagnosed primary CNS lymphoma who underwent pretreatment (18)F-FDG PET were retrospectively analyzed. Baseline status and response to treatment were evaluated by MR imaging. Tumor maximum standardized uptake values were assessed by volume-of-interest analyses using an automatic isocontour definition. A 10-step semiquantitative visual rating system (metabolic imaging lymphoma aggressiveness scale, or MILAS) was used to assess primary CNS lymphoma metabolism as a marker of clinical aggressiveness. Logistic regression, log-rank testing, and multivariable Cox regression were used to investigate the association between (18)F-FDG uptake and tumor response and survival.

RESULTS

Mean maximum standardized uptake value correlated linearly with MILAS. The distribution of patients according to MILAS (0-9) was 0%, 28.6%, 23.8%, 21.4%, 11.9%, 4.8%, 7.1%, 0%, 0%, and 2.4%. There was no correlation between MILAS and response to treatment. Respective 2- and 5-y survival rates were 52% and 32% for progression-free survival (PFS) and 64% and 50% for overall survival (OS). A cutoff at MILAS 3 was a good separator for PFS (median: 54.7 mo [≤3], 3.8 mo [>3], P = 0.0272) and OS (median: not reached [≤3], 13.8 mo [>3], P = 0.131). In multivariable analyses, increasing MILAS was significantly associated with shorter PFS (hazard ratio, 1.49, P = 0.006) and OS (hazard ratio, 1.43, P = 0.018).

CONCLUSION

Increased pretreatment (18)F-FDG uptake may offer new opportunities for baseline risk evaluation in untreated primary CNS lymphoma.

摘要

未注明

原发性中枢神经系统（CNS）淋巴瘤是一种侵袭性非霍奇金淋巴瘤，预后较差。我们评估了预处理（18）F-FDG PET 作为原发性中枢神经系统淋巴瘤的预后标志物。

方法

回顾性分析了 42 例新诊断为原发性中枢神经系统淋巴瘤的免疫功能正常患者，这些患者在接受治疗前接受了（18）F-FDG PET 检查。通过磁共振成像评估基线状态和治疗反应。使用自动等轮廓定义进行容积分析评估肿瘤最大标准化摄取值。使用 10 步半定量视觉评分系统（代谢成像淋巴瘤侵袭性评分，或 MILAS）评估原发性中枢神经系统淋巴瘤代谢作为临床侵袭性标志物。使用逻辑回归、对数秩检验和多变量 Cox 回归来研究（18）F-FDG 摄取与肿瘤反应和生存之间的关系。

结果

平均最大标准化摄取值与 MILAS 呈线性相关。根据 MILAS（0-9）对患者进行分布，结果为 0%、28.6%、23.8%、21.4%、11.9%、4.8%、7.1%、0%、0%和 2.4%。MILAS 与治疗反应无相关性。无进展生存率（PFS）的 2 年和 5 年生存率分别为 52%和 32%，总生存率（OS）分别为 64%和 50%。MILAS 为 3 是 PFS（中位数：54.7 个月[≤3]，3.8 个月[>3]，P=0.0272）和 OS（中位数：未达到[≤3]，13.8 个月[>3]，P=0.131）的良好分隔值。多变量分析显示，MILAS 增加与较短的 PFS（危险比，1.49，P=0.006）和 OS（危险比，1.43，P=0.018）显著相关。