Kurch Lars, Dührsen Ulrich, Hüttmann Andreas, Georgi Thomas W, Sabri Osama, Kluge Regine, Hasenclever Dirk
Klinik Und Poliklinik Für Nuklearmedizin, Universitätsklinikum Leipzig, Leipzig, Germany.
Klinik Für Hämatologie, Universitätsklinikum Essen, Essen, Germany.
EJNMMI Res. 2021 Sep 14;11(1):90. doi: 10.1186/s13550-021-00827-1.
Interim [F]fluoro-deoxyglucose-positron emission tomography predicts outcome in peripheral T-cell lymphoma (PTCL). We compared two quantitative evaluation methods.
Interim scans from 43 patients with anaplastic lymphoma kinase-negative PTCL from the 'Positron Emission Tomography-Guided Therapy of Aggressive Non-Hodgkin Lymphomas' trial were re-analyzed by qPET (relating residual lymphoma-related uptake to liver uptake) and ∆SUV (relating interim scan to baseline scan). The endpoint was progression-free survival.
qPET and ∆SUV were closely correlated (Pearson's r = 0.627). Up to the 60 percentile of values ranked by increasing residual activity, the positive predictive value for progression or death increased from 60 to 95%, with stable negative predictive values (NPV) of 60%. Beyond the 60 percentile, the NPV decreased to 40%. qPET ≥ 2 and ∆SUV < 50% identified high-risk populations comprising 41.9% and 39.5% of patients, with 3-year progression-free survival rates of 5.6% (95% confidence interval, 0.8-37.3) and 0%, respectively, as compared to 63.7% (47.4-85.8) and 61.3% (45.1-83.3) in low-risk patients.
qPET and ∆SUV identify large fractions of PTCL patients destined to experience treatment failure. qPET may be preferred because it requires a single PET scan, halving the diagnostic effort.
中期氟脱氧葡萄糖正电子发射断层扫描可预测外周T细胞淋巴瘤（PTCL）的预后。我们比较了两种定量评估方法。
对“侵袭性非霍奇金淋巴瘤的正电子发射断层扫描引导治疗”试验中43例间变性淋巴瘤激酶阴性PTCL患者的中期扫描进行重新分析，采用qPET（将残留淋巴瘤相关摄取与肝脏摄取相关联）和∆SUV（将中期扫描与基线扫描相关联）。终点为无进展生存期。
qPET和∆SUV密切相关（Pearson相关系数r = 0.627）。按照残留活性增加排序，直至值的第60百分位数，进展或死亡的阳性预测值从60%增加到95%，阴性预测值（NPV）稳定在60%。超过第60百分位数，NPV降至40%。qPET≥2和∆SUV<50%确定了高危人群，分别占患者的41.9%和39.5%，3年无进展生存率分别为5.6%（95%置信区间，0.8 - 37.3）和0%，而低危患者分别为63.7%（47.4 - 85.8）和61.3%（45.1 - 83.3）。
qPET和∆SUV可识别大部分注定治疗失败的PTCL患者。qPET可能更受青睐，因为它只需一次PET扫描，将诊断工作量减半。
