Albano Domenico, Laudicella Riccardo, Ferro Paola, Allocca Michela, Abenavoli Elisabetta, Buschiazzo Ambra, Castellino Alessia, Chiaravalloti Agostino, Cuccaro Annarosa, Cuppari Lea, Durmo Rexhep, Evangelista Laura, Frantellizzi Viviana, Kovalchuk Sofya, Linguanti Flavia, Santo Giulia, Bauckneht Matteo, Annunziata Salvatore
Nuclear Medicine, University of Brescia, Spedali Civili Brescia, 25123 Brescia, Italy.
Nuclear Medicine Unit, Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy.
Cancers (Basel). 2019 Nov 21;11(12):1831. doi: 10.3390/cancers11121831.
Mantle cell lymphoma (MCL) is an aggressive lymphoma subtype with poor prognosis in which 18F-FDG-PET/CT role in treatment response evaluation and prediction of outcome is still unclear. The aim of this multicentric study was to investigate the role of 18F-FDG-PET/CT in staging MCL and the prognostic role of Deauville criteria (DC) in terms of progression-free survival (PFS) and overall survival (OS). We retrospectively enrolled 229 patients who underwent baseline and end-of-treatment (eot) 18F-FDG-PET/CT after first-line therapy. EotPET/CT scans were visually interpreted according to DC. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for evaluation of bone marrow (BM) were 27%, 100%, 100%, 48% and 57%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of PET/CT for evaluation of the gastrointestinal (GI) tract were 60%, 99%, 93%, 90% and 91%, respectively. At a median follow-up of 40 months, relapse occurred in 104 cases and death in 49. EotPET/CT results using DC significantly correlated with PFS, not with OS. Instead, considering OS, only MIPI score was significantly correlated. In conclusion, we demonstrated that MCL is an FDG-avid lymphoma and 18F-FDG-PET/CT is a useful tool for staging purpose, showing good specificity for BM and GI evaluation, but suboptimal sensitivity. EotPET/CT result was the only independent significant prognostic factor that correlated with PFS.
套细胞淋巴瘤（MCL）是一种侵袭性淋巴瘤亚型，预后较差，18F-FDG-PET/CT在其治疗反应评估和预后预测中的作用仍不明确。这项多中心研究的目的是探讨18F-FDG-PET/CT在MCL分期中的作用以及Deauville标准（DC）在无进展生存期（PFS）和总生存期（OS）方面的预后作用。我们回顾性纳入了229例在一线治疗后接受基线和治疗结束时（eot）18F-FDG-PET/CT检查的患者。根据DC对eotPET/CT扫描进行视觉解读。PET/CT评估骨髓（BM）的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为27%、100%、100%、48%和57%。PET/CT评估胃肠道（GI）的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为60%、99%、93%、90%和91%。在中位随访40个月时，104例出现复发，49例死亡。使用DC的eotPET/CT结果与PFS显著相关，与OS无关。相反，考虑OS时，只有MIPI评分显著相关。总之，我们证明MCL是一种FDG摄取性淋巴瘤，18F-FDG-PET/CT是一种用于分期的有用工具，对BM和GI评估具有良好的特异性，但敏感性欠佳。eotPET/CT结果是与PFS相关的唯一独立显著预后因素。
