Zhang Xu, Fan Wei, Hu Ying-Ying, Li Zhi-Ming, Xia Zhong-Jun, Lin Xiao-Ping, Zhang Ya-Rui, Liang Pei-Yan, Li Yuan-Hua
Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, Guangdong, 510060, P. R. China.
Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, 510060, P. R. China.
Chin J Cancer. 2015 Jun 10;34(6):264-71. doi: 10.1186/s40880-015-0021-y.
Fluorine-18 fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) is a powerful tool for monitoring the response of diffuse large B-cell lymphoma (DLBCL) to therapy, but the criteria to interpret PET/CT results remain under debate. We investigated the value of post-treatment PET/CT in predicting the prognosis of DLBCL patients when interpreted according to qualitative visual trichotomous assessment (QVTA) criteria compared with the Deauville criteria.
In this retrospective study, final PET/CT scans of DLBCL patients treated with rituximab-based regimens between October 2005 and November 2010 were interpreted using the Deauville and QVTA criteria. Survival curves were estimated using Kaplan-Meier analysis and compared using the log-rank test.
A total of 253 patients were enrolled. The interpretation according to the Deauville criteria revealed that 181 patients had negative PET/CT scan results and 72 had positive results. The 3 year overall survival (OS) rate was significantly higher in patients with negative scan results than in those with positive results (91.6% vs. 57.5%, P<0.001). The 72 patients with positive scan results according to the Deauville criteria were divided into two groups by the interpretation according to the QVTA criteria: 29 had indeterminate results, and 43 had positive results. The 3 year OS rate was significantly higher in patients with indeterminate scan results than in those with positive results (91.2% vs. 33.5%, P<0.001) but was similar between patients with negative and indeterminate scan results (91.6% vs. 91.2%, P=0.921).
Compared with the Deauville criteria, using the QVTA criteria for interpreting post-treatment PET/CT scans of DLBCL patients is likely to reduce the number of false positive results. The QVTA criteria are feasible for therapeutic outcome evaluation and can be used to guide risk-adapted therapy.
氟-18氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）是监测弥漫性大B细胞淋巴瘤（DLBCL）治疗反应的有力工具，但解读PET/CT结果的标准仍存在争议。我们研究了根据定性视觉三分法评估（QVTA）标准与多维尔标准解读时，治疗后PET/CT在预测DLBCL患者预后方面的价值。
在这项回顾性研究中，对2005年10月至2010年11月期间接受基于利妥昔单抗方案治疗的DLBCL患者的最终PET/CT扫描结果，采用多维尔和QVTA标准进行解读。使用Kaplan-Meier分析估计生存曲线，并使用对数秩检验进行比较。
共纳入253例患者。根据多维尔标准解读显示PET/CT扫描结果阴性的患者有181例，阳性的有72例。扫描结果阴性患者的3年总生存率（OS）显著高于阳性患者（91.6%对57.5%，P<0.001）。根据多维尔标准扫描结果阳性的72例患者，根据QVTA标准解读分为两组：29例结果不确定，43例结果阳性。扫描结果不确定患者的3年OS率显著高于阳性患者（91.2%对33.5%，P<0.001），但阴性和不确定扫描结果患者之间相似（91.6%对91.2%，P=0.921）。
与多维尔标准相比，使用QVTA标准解读DLBCL患者治疗后的PET/CT扫描可能会减少假阳性结果的数量。QVTA标准对于治疗结果评估是可行的，可用于指导风险适应性治疗。
