Jiang Chong, Zhang Xin, Jiang Ming, Zou Liqun, Su Minggang, Kosik Russell Oliver, Tian Rong
Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, 610000, China.
Ann Nucl Med. 2015 Jun;29(5):442-51. doi: 10.1007/s12149-015-0964-8. Epub 2015 Mar 24.
Although the prognostic value of positron emission tomography/computed tomography (PET/CT) using [(18)F]-fluorodeoxyglucose ((18)F-FDG) has been widely confirmed for diffuse large B cell lymphoma, its value for extranodal natural killer/T-cell lymphoma, nasal type (ENKTL), is still controversial. Therefore, we designed a prospective study to investigate the prognostic value of (18)F-FDG PET/CT in patients with ENKTL.
Thirty-three patients with newly diagnosed, untreated ENKTL, were enrolled in this study. Interim and post-therapy PET/CT scans were analyzed by visual evaluation, in accordance with the criteria set forth by the International Harmonization Project. Patients were classified as either positive or negative. Pretreatment maximum standardized uptake values (SUVmax) of (18)F-FDG were recorded in the most (18)F-FDG-intense lesions. The pretreatment (18)F-FDG SUV as well as the interim and post-therapy PET/CT results were assessed for the ability to predict progression-free survival (PFS) and overall survival (OS).
On the pretreatment scan, the SUVmax of the indicator lesion was >10.00 in 81.8% of patients who were treatment-resistant and ≤10.00 in 86.4% of patients who were treatment non-resistant (mean SUVmax, 12.93 and 8.10, respectively). Univariate analyses revealed that pretreatment SUVmax is a significant predictor (P < 0.01, P < 0.01) of PFS and OS, respectively. Multivariate analyses revealed that pretreatment SUVmax (P < 0.01, P = 0.01) and post-therapy PET/CT result (P < 0.01, P = 0.04) are independent predictors of PFS and OS, respectively.
(18)F-FDG uptakes prior to treatment and post-therapy PET/CT results can predict unfavorable outcomes following treatment in patients with ENKTL, but interim PET/CT results have little value in predicting survival.
尽管使用[（18）F] - 氟脱氧葡萄糖（（18）F - FDG）的正电子发射断层扫描/计算机断层扫描（PET/CT）对弥漫性大B细胞淋巴瘤的预后价值已得到广泛证实，但其对结外自然杀伤/T细胞淋巴瘤鼻型（ENKTL）的价值仍存在争议。因此，我们设计了一项前瞻性研究，以探讨（18）F - FDG PET/CT在ENKTL患者中的预后价值。
33例新诊断、未治疗的ENKTL患者纳入本研究。根据国际协调项目制定的标准，通过视觉评估分析治疗期间和治疗后的PET/CT扫描。患者分为阳性或阴性。记录最强烈摄取（18）F - FDG的病变中（18）F - FDG的治疗前最大标准化摄取值（SUVmax）。评估治疗前（18）F - FDG SUV以及治疗期间和治疗后的PET/CT结果预测无进展生存期（PFS）和总生存期（OS）的能力。
在治疗前扫描中，治疗耐药患者中81.8%的指示病变SUVmax>10.00，治疗不耐药患者中这一比例为86.4%（平均SUVmax分别为12.93和8.10）。单因素分析显示，治疗前SUVmax分别是PFS和OS的显著预测因子（P<0.01，P<0.01）。多因素分析显示，治疗前SUVmax（P<0.01，P = 0.01）和治疗后PET/CT结果（P<0.01，P = 0.04）分别是PFS和OS的独立预测因子。
治疗前（18）F - FDG摄取及治疗后PET/CT结果可预测ENKTL患者治疗后的不良结局，但治疗期间PET/CT结果对预测生存价值不大。
