Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University.
Department of Radiology, Nissan Tamagwa Hospital, Tokyo.
Nucl Med Commun. 2020 Jun;41(6):567-574. doi: 10.1097/MNM.0000000000001197.
This study aimed to clarify the relationship between tumor redox reaction evaluated by Cu-diacetyl-bis (N4-methylthiosemicarbazone) (Cu-ATSM) PET/computed tomography (CT) and disease-free survival (DFS) in patients with primary diffuse large B-cell lymphoma of the central nervous system (DLBCL-CNS).
Fifteen consecutive patients with histologically confirmed DLBCL-CNS underwent preoperative Cu-ATSM PET/CT and F-fluorodeoxyglucose (FDG) PET/CT. Statistical features of seven first-order parameters, including the standardized uptake value (SUV); 12 second-order parameters, including gray-level co-occurrence matrices and gray-level zone size matrices; and 5 high-order parameters, including neighborhood gray-tone difference matrices, were calculated from the volume of interest. We compared DFS with parameters, including SUVmax and tumor-to-background (T/B) ratio of FDG, and SUVmax, T/B ratio, and other textural features of Cu-ATSM.
The mean follow-up duration after PET/CT was 458 (range, 41-1071) days. The SUVmax of FDG was significantly higher than that of Cu-ATSM (P = 0.001), but the T/B ratio was not significantly different between the scans (3.49 ± 2.29 vs 2.48 ± 1.18; P = 0.244). A Mantel-Cox log-rank test revealed no significant association between SUVmax of FDG and DFS (P = 0.641). A high SUVmax of Cu-ATSM had a tendency of shorter DFS (P = 0.055). Total lesion reduction, reductive tumor volume, and T/B ratio of Cu-ATSM were significantly correlated with poor DFS by univariate analysis (P = 0.049, 0.031, and 0.007, respectively). Neighborhood gray-level co-occurrence matrix dissimilarity was significantly correlated with poor DFS (P = 0.015).
Metabolic and textural features derived from pretreatment Cu-ATSM PET/CT could be used for predicting DFS and establishing a novel treatment strategy in DLBCL-CNS patients.
本研究旨在阐明通过 Cu-二乙酰基双（N4-甲基硫代半卡巴腙）（Cu-ATSM）正电子发射断层扫描/计算机断层扫描（PET/CT）评估肿瘤氧化还原反应与原发性中枢神经系统弥漫性大 B 细胞淋巴瘤（DLBCL-CNS）患者无病生存（DFS）之间的关系。
15 例经组织学证实的中枢神经系统弥漫性大 B 细胞淋巴瘤患者术前均行 Cu-ATSM PET/CT 和 F-氟脱氧葡萄糖（FDG）PET/CT 检查。从感兴趣区域计算 7 个一阶参数（包括标准化摄取值[SUV]）、12 个二阶参数（包括灰度共生矩阵和灰度区域大小矩阵）和 5 个高阶参数（包括邻域灰度差矩阵）的统计特征。我们比较了包括 FDG 的 SUVmax 和肿瘤与背景（T/B）比值在内的参数与包括 Cu-ATSM 的 SUVmax、T/B 比值和其他纹理特征在内的参数与 DFS 的关系。
PET/CT 后平均随访时间为 458（41-1071）天。FDG 的 SUVmax 明显高于 Cu-ATSM（P=0.001），但扫描的 T/B 比值无显著差异（3.49±2.29 比 2.48±1.18；P=0.244）。Mantel-Cox 对数秩检验显示 FDG 的 SUVmax 与 DFS 无显著相关性（P=0.641）。高 SUVmax 的 Cu-ATSM 有DFS 较短的趋势（P=0.055）。单因素分析显示，总病灶减少率、还原肿瘤体积和 Cu-ATSM 的 T/B 比值与不良 DFS 显著相关（P=0.049、0.031 和 0.007）。邻域灰度共生矩阵差异与不良 DFS 显著相关（P=0.015）。
治疗前 Cu-ATSM PET/CT 获得的代谢和纹理特征可用于预测 DLBCL-CNS 患者的 DFS，并为建立新的治疗策略提供依据。
