Department of Hematology, Gustave Roussy and Université Paris Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and Université Paris Saclay, 114 Rue Edouard Vaillant, 94805, Villejuif, France.
Eur J Nucl Med Mol Imaging. 2017 Nov;44(12):2018-2024. doi: 10.1007/s00259-017-3758-5. Epub 2017 Jun 21.
Though commonly used to assess response to therapy, the prognostic value of interim FDG-PET/CT in Primary Mediastinal Large B-cell Lymphoma (PMBCL) is unclear.
We conducted a retrospective study on 36 consecutive patients treated at our institution for a PMBCL between 2006 and 2014. All patients with a positive interim FDG-PET/CT had undergone histological restaging consisting either in a surgical debulking of the residual lesion (15 patients) or a CT-guided core needle biopsy (two patients). All FDG-PET/CT were secondarily reviewed according to the more recent Deauville criteria.
Interim FDG-PET/CT was considered positive in 17/36 patients using visual evaluation. Among these patients, 14 had a Deauville score of 4. Histological restaging was negative in all but one case, showing inflammation and/or fibrosis. After a median follow-up of 48.5 months, a total of five patients have relapsed, two patients in the positive FDG-PET/CT group, and three patients in the negative FDG-PET/CT group, respectively.
These data indicate that a positive interim FDG-PET/CT does not reflect persistence of active disease in the vast majority of PMBCL cases. The relapse rate appears similar regardless of interim FDG-PET/CT results and interpretation criteria. This suggests that interim FDG-PET/CT has a poor positive predictive value, thus kt should be used with caution in PMBCL.
虽然常用于评估治疗反应，但原发纵隔大 B 细胞淋巴瘤（PMBCL）中中期 FDG-PET/CT 的预后价值尚不清楚。
我们对 2006 年至 2014 年期间在我院接受治疗的 36 例连续 PMBCL 患者进行了回顾性研究。所有中期 FDG-PET/CT 阳性的患者均接受了组织学分期，包括残留病变的手术减瘤（15 例）或 CT 引导下的核心针活检（2 例）。所有 FDG-PET/CT 根据最近的 Deauville 标准进行二次审查。
根据视觉评估，36 例患者中有 17 例中期 FDG-PET/CT 结果阳性。这些患者中，14 例 Deauville 评分为 4 分。除 1 例外，所有患者的组织学分期均为阴性，表现为炎症和/或纤维化。中位随访 48.5 个月后，共有 5 例患者复发，阳性 FDG-PET/CT 组 2 例，阴性 FDG-PET/CT 组 3 例。
这些数据表明，在大多数 PMBCL 病例中，阳性的中期 FDG-PET/CT 并不反映持续存在活动性疾病。无论中期 FDG-PET/CT 结果和解释标准如何，复发率似乎相似。这表明中期 FDG-PET/CT 的阳性预测值较差，因此在 PMBCL 中应谨慎使用。
