Nuclear Medicine Department, University of Brescia and ASST Spedali Civili of Brescia, 25123 Brescia, Italy.
Medicina (Kaunas). 2021 May 14;57(5):498. doi: 10.3390/medicina57050498.
: Primary gastric diffuse large-B cell lymphoma (DLBCL) is an aggressive lymphoma subtype with high F-FDG avidity but unclear criteria for 2-[F]-FDG PET/CT in the evaluation of treatment response and prognostication. Our aim was to investigate whether the pretreatment 2-[F]-FDG PET/CT variables may predict treatment response (at end of first-line therapy) and prognosis in primary gastric DLBCL. : we included 57 patients with a diagnosis of primary gastric DLBCL and a baseline 2-[F]-FDG PET/CT and an end of treatment PET/CT after 6 cycles of R-CHOP chemotherapy. We analyzed PET images qualitatively and semi-quantitatively by deriving the maximum standardized uptake value body weight (SUVbw), the maximum standardized uptake value lean body mass (SUVlbm), the maximum standardized uptake value body surface area (SUVbsa), lesion to liver SUVmax ratio (L-L SUV R), lesion to blood-pool SUVmax ratio (L-BP SUV R), metabolic tumor volume and total lesion glycolysis of gastric lesion (gMTV and gTLG), and total MTV (tMTV) and TLG. Survival curves were plotted according to the Kaplan-Meier analysis. at a median follow up of 80 months, the median PFS and OS were 69 and 80 months. Baseline gMTV, gTLG, tMTV, and TLG were significantly higher in patients with incomplete response (partial response and progression) compared to complete response group. tMTV and TLG were confirmed to be independent prognostic factors both for PFS ( = 0.023 and = 0.038) and OS ( = 0.038 and = 0.026); instead, the other metabolic parameters were not related to outcome survival. : high tMTV and TLG were significantly correlated with shorter survival (PFS and OS) and may predict incomplete response after therapy.
胃原发性弥漫性大 B 细胞淋巴瘤（DLBCL）是一种侵袭性淋巴瘤亚型，对 F-FDG 摄取率高，但 2-[F]-FDG PET/CT 在评估治疗反应和预后方面的标准尚不清楚。我们的目的是研究治疗前 2-[F]-FDG PET/CT 变量是否可预测胃原发性 DLBCL 的治疗反应（一线治疗结束时）和预后。
我们纳入了 57 例经诊断为胃原发性 DLBCL 并基线进行了 2-[F]-FDG PET/CT 检查、且在 R-CHOP 化疗 6 周期后进行了治疗结束 PET/CT 检查的患者。我们通过获得最大标准化摄取值体重（SUVbw）、最大标准化摄取值去脂体重（SUVlbm）、最大标准化摄取值体表面积（SUVbsa）、病灶与肝脏 SUVmax 比值（L-L SUV R）、病灶与血池 SUVmax 比值（L-BP SUV R）、胃病灶的代谢肿瘤体积和总病灶糖酵解（gMTV 和 gTLG）、总 MTV（tMTV）和 TLG 对 PET 图像进行定性和半定量分析。根据 Kaplan-Meier 分析绘制生存曲线。
在中位随访 80 个月时，中位 PFS 和 OS 分别为 69 和 80 个月。与完全缓解组相比，不完全缓解（部分缓解和进展）患者的基线 gMTV、gTLG、tMTV 和 TLG 显著更高。tMTV 和 TLG 被证实是 PFS（=0.023 和=0.038）和 OS（=0.038 和=0.026）的独立预后因素；而其他代谢参数与生存结果无关。
高 tMTV 和 TLG 与较短的生存（PFS 和 OS）显著相关，并且可能预测治疗后的不完全缓解。
