不同 PET 和 CT 基于的影像学解读标准在弥漫性大 B 细胞淋巴瘤患者中期影像学中的比较。
Comparison Between Different PET and CT-Based Imaging Interpretation Criteria at Interim Imaging in Patients With Diffuse Large B-Cell Lymphoma.
出版信息
Clin Nucl Med. 2018 Jan;43(1):1-8. doi: 10.1097/RLU.0000000000001880.
OBJECTIVE
To evaluate the predictive value of interim PET (iPET) in diffuse large B-cell lymphoma (DLBCL) using 5 different imaging interpretation criteria: Deauville 5-point scale criteria, International Harmonization Project (IHP) criteria, Response Evaluation Criteria In Solid Tumors (RECIST) 1.1, European Organization for Research and Treatment of Cancer, and PET Response Criteria in Solid Tumors (PERCIST) 1.0.
METHODS
We retrospectively reviewed records from 38 patients with DLBCL who underwent baseline and iPET at our institution. Imaging was interpreted according to the previously mentioned criteria. Results were correlated with end-of-treatment response, based on reports at the end of treatment radiological examinations, overall survival (OS), and progression-free survival (PFS) to assess and compare the predictive value of iPET according to each criterion. We also evaluated the concordance between different criteria.
RESULTS
The Deauville and PERCIST criteria were the most reliable for predicting end-of-treatment response, reporting an accuracy of 81.6%. They also correlated with OS and PFS (P = 0.0004 and P = 0.0001, and P = 0.0007 and P = 0.0002, for Deauville and PERCIST, respectively). Interim PET according to European Organization for Research and Treatment of Cancer also predicted the end-of-treatment response with an accuracy of 73.7% and had a significant correlation with OS (P = 0.007) and PFS (P = 0.007). In contrast, the IHP criteria and RECIST did not predict outcomes: the accuracy for end-of-treatment response was 34.2% and 36.8%, respectively, with no significant correlation with OS or PFS (P = 0.182 and P = 0.357, and P = 0.341 and P = 0.215, for OS and PFS, respectively).
CONCLUSIONS
The predictive value of iPET in DLBCL patients is most reliable using the Deauville and PERCIST criteria. Criteria that rely on anatomical characteristics, namely, RECIST and IHP criteria, are less accurate in predicting patient outcomes in DLBCL.
目的
使用 5 种不同的影像解读标准，即 Deauville 5 分制标准、国际协调计划（IHP）标准、实体瘤反应评估标准 1.1（RECIST 1.1）、欧洲癌症研究与治疗组织（EORTC）和实体瘤 PET 反应标准（PERCIST）1.0，评估弥漫性大 B 细胞淋巴瘤（DLBCL）中中期 PET（iPET）的预测价值。
方法
我们回顾性分析了在我院接受基线和 iPET 检查的 38 例 DLBCL 患者的病历。根据上述标准进行影像学解读。根据治疗结束时的影像学检查报告、总生存期（OS）和无进展生存期（PFS）来评估 iPET 的预测价值，并比较每种标准的预测价值。我们还评估了不同标准之间的一致性。
结果
Deauville 和 PERCIST 标准对预测治疗结束时的反应最可靠，准确性为 81.6%。它们还与 OS 和 PFS 相关（P=0.0004 和 P=0.0001，P=0.0007 和 P=0.0002，分别为 Deauville 和 PERCIST）。根据欧洲癌症研究与治疗组织的 iPET 也可以以 73.7%的准确率预测治疗结束时的反应，与 OS（P=0.007）和 PFS（P=0.007）显著相关。相比之下，IHP 标准和 RECIST 标准不能预测结局：治疗结束时反应的准确性分别为 34.2%和 36.8%，与 OS 或 PFS 均无显著相关性（P=0.182 和 P=0.357，P=0.341 和 P=0.215，分别为 OS 和 PFS）。
结论
在 DLBCL 患者中，iPET 的预测价值最可靠的是 Deauville 和 PERCIST 标准。依赖于解剖特征的标准，即 RECIST 和 IHP 标准，在预测 DLBCL 患者的预后方面准确性较低。
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