淋巴瘤患者预后评估中代谢标准的优化。一项多中心研究。
Optimisation of metabolic criteria in the prognostic assessment in patients with lymphoma. A multicentre study.
作者信息
Del Puig Cózar-Santiago M, García-Garzón J R, Moragas-Freixa M, Soler-Peter M, Bassa Massanas P, Sánchez-Delgado M, Sanchez-Jurado R, Aguilar-Barrios J E, Sanz-Llorens R, Ferrer-Rebolleda J
机构信息
Servicio de Medicina Nuclear, ERESA-Hospital General Universitario de Valencia, Valencia, España.
Unidad PET Esplugues, Cetir-ERESA, Esplugues de Llobregat, Barcelona, España.
出版信息
Rev Esp Med Nucl Imagen Mol. 2017 Sep-Oct;36(5):304-311. doi: 10.1016/j.remn.2017.03.003. Epub 2017 May 5.
OBJECTIVE
To compare sensitivity, specificity and predictive value of Deauville score (DS) vs. ΔSUVmax in interim-treatment PET (iPET) and end-treatment PET (ePET), in patients with diffuse large B cell lymphoma (DLBCL), Hodgkin lymphoma (HL), and follicular lymphoma (FL).
METHOD
Retrospective longitudinal multicentre study including 138 patients (46 DLBCL, 46 HL, 46 FL), on whom 3 F-FDG PET/CT were performed: baseline, iPET, and ePET. Visual (DS) and semi-quantitative (ΔSUVmax) parameters were determined for iPET and ePET. Predictive value was determined in relation to disease-free interval.
RESULTS
Statistical analysis. iPET for DLBCL, HL, and FL: 1) sensitivity of DS: 76.92/83.33/61.53%; specificity: 78.78/85/81.81%; 2) sensitivity of ΔSUVmax: 53.84/83.33/61.53%; specificity: 87.87/87.50/78.78%. ePET for DLBCL, HL and FL: 1) sensitivity of DS: 61.53/83.33/69.23%; specificity: 90.90/85/87.87%; 2) sensitivity of ΔSUVmax: 69.23/83.33/69.23%; specificity: 90.90/87.50/84.84%. Predictive assessment. iPET study: in DLBCL, DS resulted in 10.3% recurrence of negative iPET, and 17.1% in ΔSUVmax at disease-free interval; in HL, both parameters showed a 2.8% recurrence of negative iPET; in FL, DS resulted in 15.6% recurrence of negative iPET, and 16.1% in ΔSUVmax, with no statistical significance. ePET study: in DLBCL, DS resulted in 14.3% recurrence of negative ePET, and 11.8% in ΔSUVmax at disease-free interval; in HL and FL, both methods showed 2.8 and 12.5% recurrence in negative ePET, respectively.
CONCLUSION
DS and ΔSUVmax did not show significant differences in DLBCL, HL and FL. Their predictive value also did not show significant differences in HL and FL. In DLBCL, DS was higher in iPET, and ΔSUVmax in ePET.
目的
比较多维尔评分（DS）与最大标准摄取值变化（ΔSUVmax）在弥漫性大B细胞淋巴瘤（DLBCL）、霍奇金淋巴瘤（HL）和滤泡性淋巴瘤（FL）患者的中期治疗正电子发射断层显像（iPET）和终末期治疗正电子发射断层显像（ePET）中的敏感性、特异性和预测价值。
方法
回顾性纵向多中心研究，纳入138例患者（46例DLBCL、46例HL、46例FL），对其进行3次氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（F-FDG PET/CT）检查：基线检查、iPET检查和ePET检查。确定iPET和ePET的视觉（DS）和半定量（ΔSUVmax）参数。根据无病生存期确定预测价值。
结果
统计分析。DLBCL、HL和FL的iPET：1）DS的敏感性：76.92%/83.33%/61.53%；特异性：78.78%/85%/81.81%；2）ΔSUVmax的敏感性：53.84%/83.33%/61.53%；特异性：87.87%/87.50%/78.78%。DLBCL、HL和FL的ePET：1）DS的敏感性：61.53%/83.33%/69.23%；特异性：90.90%/85%/87.87%；2）ΔSUVmax的敏感性：69.23%/83.33%/69.23%；特异性：90.90%/87.50%/84.84%。预测评估。iPET研究：在DLBCL中，DS导致iPET阴性患者的复发率为10.3%，ΔSUVmax在无病生存期的复发率为17.1%；在HL中，两个参数显示iPET阴性患者的复发率均为2.8%；在FL中，DS导致iPET阴性患者的复发率为15.6%，ΔSUVmax为16.1%，无统计学意义。ePET研究：在DLBCL中，DS导致ePET阴性患者的复发率为14.3%，ΔSUVmax在无病生存期的复发率为11.8%；在HL和FL中，两种方法显示ePET阴性患者的复发率分别为2.8%和12.5%。
结论
DS和ΔSUVmax在DLBCL、HL和FL中未显示出显著差异。它们的预测价值在HL和FL中也未显示出显著差异。在DLBCL中，iPET时DS较高，ePET时ΔSUVmax较高。
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