Department of Nuclear Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Department of Clinical Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Eur J Nucl Med Mol Imaging. 2018 Jul;45(7):1142-1154. doi: 10.1007/s00259-018-3953-z. Epub 2018 Feb 19.
Metabolic tumour volume (MTV) is a promising prognostic indicator in diffuse large B cell lymphoma (DLBCL). Optimal thresholds to divide patients into 'low' versus 'high' MTV groups depend on clinical characteristics and the measurement method. The aim of this study was to compare in consecutive unselected patients with DLBCL, different software algorithms and published methods of MTV measurement using FDG PET.
Pretreatment MTV was measured on 147 patients treated at Guy's and St Thomas' Hospital. We compared 3 methods: SUV ≥2.5, SUV ≥41% of maximum SUV and SUV ≥ mean liver uptake (PERCIST) and compared 2 software programs for measuring SUV ≥2.5; in-house 'PETTRA' software and Hermes commercial software.
There was strong correlation between MTV using the 4 methods, although derived thresholds were very different for the 41% method. Optimal cut-offs for predicting PFS ranged from 166-400cm. All methods predicted survival with similar accuracy. 5y-PFS was 83-87% vs. 42-44% and 5y-OS was 85-89% vs. 55-58% for the low- and high-MTV groups, respectively. Interobserver variation in 50 patients showed excellent agreement, though variation was lowest using the SUV ≥ 2.5 method. The 41% method was the most complex and took the longest time.
All methods predicted PFS and OS with similar accuracy, but the derived cut-off separating good from poor prognosis varied markedly depending on the method. The choice of the optimal method should rely primarily on prognostic value, but for clinical use needs to take account of ease of use and reproducibility. In this study, all methods predicted prognosis, but SUV ≥ 2.5 had the best inter-observer agreement and was easiest to apply.
代谢肿瘤体积（MTV）是弥漫性大 B 细胞淋巴瘤（DLBCL）有前途的预后指标。将患者分为“低”与“高”MTV 组的最佳阈值取决于临床特征和测量方法。本研究的目的是在连续的未经选择的 DLBCL 患者中比较使用 FDG PET 测量 MTV 的不同软件算法和已发表的方法。
对在盖伊医院和圣托马斯医院治疗的 147 例患者进行了预处理 MTV 测量。我们比较了 3 种方法：SUV≥2.5、SUV≥41%最大 SUV 和 SUV≥平均肝脏摄取（PERCIST），并比较了用于测量 SUV≥2.5 的 2 种软件程序；内部的“PETTRA”软件和 Hermes 商业软件。
尽管 41%方法的衍生阈值差异很大，但使用这 4 种方法测量的 MTV 之间存在很强的相关性。预测 PFS 的最佳截止值范围为 166-400cm。所有方法对生存的预测准确性相似。低 MTV 组的 5 年 PFS 为 83-87%，而高 MTV 组的 5 年 PFS 为 42-44%；低 MTV 组的 5 年 OS 为 85-89%，而高 MTV 组的 5 年 OS 为 55-58%。在 50 例患者中，观察者间变异显示出极好的一致性，尽管使用 SUV≥2.5 方法时变异最低。41%方法最复杂，耗时最长。
所有方法对 PFS 和 OS 的预测准确性相似，但区分预后良好与不良的衍生截止值因方法而异。最佳方法的选择应主要取决于预后价值，但在临床应用中需要考虑易用性和可重复性。在本研究中，所有方法均预测了预后，但 SUV≥2.5 具有最佳的观察者间一致性，并且最容易应用。
Zotero 插件
