Annunziata Salvatore, Cuccaro Annarosa, Calcagni Maria Lucia, Hohaus Stefan, Giordano Alessandro, Rufini Vittoria
Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Institute of Hematology, Università Cattolica del Sacro Cuore, Rome, Italy.
Ann Nucl Med. 2016 Oct;30(8):588-92. doi: 10.1007/s12149-016-1092-9. Epub 2016 May 31.
To evaluate the prognostic role of the ratio between target lesion and liver SUVmax (rPET) in patients with Hodgkin lymphoma (HL) undergoing interim FDG-PET/CT and to compare rPET with the 5-point Deauville Score (5p-DS).
Sixty-eight patients with HL undergoing interim FDG-PET/CT after first courses of chemotherapy were evaluated. The receiver operating characteristic (ROC) approach was applied to identify the optimal cutpoint of rPET with respect to progression free survival (PFS). The prognostic significance of rPET was compared with 5p-DS (scores 4 and 5 considered as positive). Positive predictive value (PPV) and negative predictive value (NPV) were calculated using the presence of an adverse event as the gold standard.
The ROC analysis for rPET as a predictor of progression showed an optimal rPET cutpoint of 1.14. Both 5p-DS and rPET were strong outcome predictors (p < 0.001). Patients with negative 5p-DS and patients with rPET <1.14 had a similar two-year PFS (86 and 87 %, respectively). Patients with a positive 5p-DS had a 2-year PFS of 27 %, while patients with rPET >1.14 had a 2-year PFS of 15 %. 5p-DS and rPET cutoff of 1.14 showed a PPV of 58 versus 70 %, and a NPV of 85 versus 86 %, respectively.
rPET could be considered an accurate prognostic factor in patients with HL undergoing interim FDG-PET/CT. Larger prospective studies are needed to confirm these data.
评估霍奇金淋巴瘤（HL）患者在接受中期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）时，靶病灶与肝脏最大标准摄取值之比（rPET）的预后作用，并将rPET与5分的多维尔评分（5p-DS）进行比较。
对68例在首轮化疗后接受中期FDG-PET/CT的HL患者进行评估。采用受试者操作特征（ROC）方法确定rPET相对于无进展生存期（PFS）的最佳切点。将rPET的预后意义与5p-DS（4分和5分视为阳性）进行比较。以不良事件的发生作为金标准计算阳性预测值（PPV）和阴性预测值（NPV）。
rPET作为进展预测指标的ROC分析显示最佳rPET切点为1.14。5p-DS和rPET都是强有力的预后预测指标（p < 0.001）。5p-DS阴性的患者和rPET < 1.14的患者两年PFS相似（分别为86%和87%）。5p-DS阳性的患者两年PFS为27%，而rPET > 1.14的患者两年PFS为15%。5p-DS和rPET切点为1.14时，PPV分别为58%和70%，NPV分别为85%和86%。
rPET可被视为接受中期FDG-PET/CT的HL患者的准确预后因素。需要更大规模的前瞻性研究来证实这些数据。
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