Parvez Aatif, Tau Noam, Hussey Douglas, Maganti Manjula, Metser Ur
Joint Department of Medical Imaging, Princess Margaret Cancer Centre, University Health Network, Mount Sinai Hospital and Women's College Hospital, University of Toronto, 610 University Ave, Suite 3-960, Toronto, ON, M5G 2M9, Canada.
Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada.
Ann Nucl Med. 2018 Jul;32(6):410-416. doi: 10.1007/s12149-018-1260-1. Epub 2018 May 12.
To determine whether metabolic tumor parameters and radiomic features extracted from F-FDG PET/CT (PET) can predict response to therapy and outcome in patients with aggressive B-cell lymphoma.
This institutional ethics board-approved retrospective study included 82 patients undergoing PET for aggressive B-cell lymphoma staging. Whole-body metabolic tumor volume (MTV) using various thresholds and tumor radiomic features were assessed on representative tumor sites. The extracted features were correlated with treatment response, disease-free survival (DFS) and overall survival (OS).
At the end of therapy, 66 patients (80.5%) had shown complete response to therapy. The parameters correlating with response to therapy were bulky disease > 6 cm at baseline (p = 0.026), absence of a residual mass > 1.5 cm at the end of therapy CT (p = 0.028) and whole-body MTV with best performance using an SUV threshold of 3 and 6 (p = 0.015 and 0.009, respectively). None of the tumor texture features were predictive of first-line therapy response, while a few of them including GLNU correlated with disease-free survival (p = 0.013) and kurtosis correlated with overall survival (p = 0.035).
Whole-body MTV correlates with response to therapy in patient with aggressive B-cell lymphoma. Tumor texture features could not predict therapy response, although several features correlated with the presence of a residual mass at the end of therapy CT and others correlated with disease-free and overall survival. These parameters should be prospectively validated in a larger cohort to confirm clinical prognostication.
确定从F-FDG PET/CT（PET）中提取的代谢肿瘤参数和放射组学特征是否可预测侵袭性B细胞淋巴瘤患者的治疗反应和预后。
这项经机构伦理委员会批准的回顾性研究纳入了82例因侵袭性B细胞淋巴瘤分期而接受PET检查的患者。在代表性肿瘤部位评估使用各种阈值的全身代谢肿瘤体积（MTV）和肿瘤放射组学特征。提取的特征与治疗反应、无病生存期（DFS）和总生存期（OS）相关。
治疗结束时，66例患者（80.5%）对治疗显示完全缓解。与治疗反应相关的参数包括基线时肿块较大（>6 cm，p = 0.026）、治疗结束时CT检查无残留肿块>1.5 cm（p = 0.028）以及使用SUV阈值3和6时全身MTV表现最佳（分别为p = 0.015和0.009）。没有肿瘤纹理特征可预测一线治疗反应，而其中一些特征包括GLNU与无病生存期相关（p = 0.013），峰度与总生存期相关（p = 0.035）。
全身MTV与侵袭性B细胞淋巴瘤患者对治疗的反应相关。肿瘤纹理特征无法预测治疗反应，尽管一些特征与治疗结束时CT检查的残留肿块存在相关，其他特征与无病生存期和总生存期相关。这些参数应在更大的队列中进行前瞻性验证以确认临床预后。
