Jiang Chong, Teng Yue, Chen Jieyu, Wang Zhen, Zhou Zhengyang, Ding Chongyang, Xu Jingyan
Department of Nuclear Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
EJNMMI Res. 2020 Sep 23;10(1):110. doi: 10.1186/s13550-020-00698-y.
The aim of this study was to explore the prognostic value of total metabolic tumor volume (TMTV) at baseline F-FDG PET/CT in patients diagnosed with peripheral T-cell lymphoma (PTCL).
Eighty-four newly diagnosed PTCL patients who underwent baseline F-FDG PET/CT prior to treatment between March 2009 and January 2019 were enrolled in this retrospective study. The FDG-avid lesions in each patient were segmented using semiautomated software to calculate the maximum standardized uptake value (SUVmax), total metabolic tumor volume (TMTV), and total lesion glycolysis (TLG) values using the boundaries of voxels presenting with the 41% SUVmax threshold method. Progression-free survival (PFS) and overall survival (OS) were used as end points to evaluate patient prognosis. The log-rank test and Cox regression analyses were used to evaluate PFS and OS.
ROC curve analysis indicated an ideal TMTV cut-off value of 228.8 cm. During the 4-131 months (29.2 ± 28.5 months) follow-up period, high TMTV was significantly associated with worse PFS and OS. TMTV and the international peripheral T-cell lymphoma project score (IPTCLP) were independent predictors of PFS and OS with multivariate analysis. The combination of TMTV and the IPTCLP may provide significantly better risk substratification in PFS and OS of PTCL patients.
Both TMTV and IPTCLP are independent predictors of PTCL patient survival outcomes. Moreover, the combination of TMTV and IPTCLP improved patient risk stratification and may contribute to personalized therapeutic regimens.
本研究旨在探讨基线F-FDG PET/CT检查时总代谢肿瘤体积(TMTV)对诊断为外周T细胞淋巴瘤(PTCL)患者的预后价值。
本回顾性研究纳入了2009年3月至2019年1月期间84例新诊断的PTCL患者,这些患者在治疗前均接受了基线F-FDG PET/CT检查。使用半自动软件对每位患者的FDG摄取病灶进行分割,采用41%SUVmax阈值法,根据体素边界计算最大标准化摄取值(SUVmax)、总代谢肿瘤体积(TMTV)和总病灶糖酵解(TLG)值。无进展生存期(PFS)和总生存期(OS)作为评估患者预后的终点指标。采用对数秩检验和Cox回归分析评估PFS和OS。
ROC曲线分析表明,理想的TMTV临界值为228.8 cm³。在4-131个月(29.2±28.5个月)的随访期内,高TMTV与较差的PFS和OS显著相关。多因素分析显示,TMTV和国际外周T细胞淋巴瘤项目评分(IPTCLP)是PFS和OS的独立预测因素。TMTV与IPTCLP的联合应用在PTCL患者的PFS和OS中可能提供明显更好的风险分层。
TMTV和IPTCLP均为PTCL患者生存结局的独立预测因素。此外,TMTV与IPTCLP的联合应用改善了患者的风险分层,并可能有助于制定个性化治疗方案。