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基于SUV的解读能否提高弥漫性大B细胞淋巴瘤患者治疗中期及治疗后F-FDG PET/CT的预后准确性?

Can the SUV-based interpretation improve prognostic accuracy of interim and posttreatment F-FDG PET/CT in patients with diffuse large B-cell lymphoma?

作者信息

Zhang Yuewei, Fan Yang, Ying Zhitao, Song Yuqin, Zhu Jun, Yang Zhi, Wang Xuejuan

机构信息

a Department of Nuclear Medicine, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) , Peking University Cancer Hospital & Institute , Beijing, P.R. China.

b Department of Lymphoma, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education) , Peking University Cancer Hospital & Institute , Beijing, P.R. China.

出版信息

Leuk Lymphoma. 2018 Mar;59(3):660-669. doi: 10.1080/10428194.2017.1357171. Epub 2017 Aug 3.

Abstract

In order to investigate whether the SUV-based interpretation could improve prognostic accuracy of interim (PET-4) and posttreatment PET/CT (PET-end), 115 patients with newly diagnosed DLBCL were recruited in the study. ROC analysis revealed the optimal threshold is 1.6-fold of SUV for PET-4 and 1.4-fold of SUV for PET-end. The SUV-based interpretation had a perfect interobserver agreement, higher prognostic accuracy and positive predictive value than 5-point scale and %ΔSUV criteria in both PET-4 and PET-end. Dramatic differences in the outcome between patients with positive and negative PET-4/PET-end were demonstrated using Kaplan-Meier survival curves (p < .05). Univariate and multifactor analysis found PET-4 and PET-end were independent prognostic factors for the outcome of DLBCL. In conclusion, the SUV-based interpretation were superior to 5-point scale and %ΔSUV criteria in analyzing the PET-4 and PET-end for the prognosis of DLBCL patients.

摘要

为了研究基于标准化摄取值(SUV)的解读是否能提高中期(PET-4)及治疗后PET/CT(PET-end)的预后准确性,本研究纳入了115例新诊断的弥漫性大B细胞淋巴瘤(DLBCL)患者。ROC分析显示,PET-4的最佳阈值为SUV的1.6倍,PET-end的最佳阈值为SUV的1.4倍。在PET-4和PET-end中,基于SUV的解读在观察者间一致性、预后准确性和阳性预测值方面均优于5分制和SUV变化百分比标准。使用Kaplan-Meier生存曲线显示,PET-4/PET-end阳性和阴性患者的预后存在显著差异(p < .05)。单因素和多因素分析发现,PET-4和PET-end是DLBCL预后的独立预后因素。总之,在分析DLBCL患者的PET-4和PET-end预后时,基于SUV的解读优于5分制和SUV变化百分比标准。

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