Albano Domenico, Pasinetti Nadia, Dondi Francesco, Giubbini Raffaele, Tucci Alessandra, Bertagna Francesco
Nuclear Medicine, ASST Spedali Civili Brescia, 25128 Brescia, Italy.
Nuclear Medicine Department, University of Brescia, 25121 Brescia, Italy.
J Clin Med. 2022 Feb 23;11(5):1210. doi: 10.3390/jcm11051210.
The goal of this retrospective study was to analyze and compare the prognostic role of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (2-[F]-FDG PET/CT) features and sarcopenia, estimated by CT of PET in elderly (≥65 years) Mantle Cell Lymphoma (MCL). We recruited 53 patients, who underwent pre-treatment 2-[F]-FDG PET/CT and end-of-treatment PET/CT, and the main semiquantitative parameters were calculated. Sarcopenia was measured as skeletal muscle index (SMI, cm/m) and derived by low-dose PET/CT images at the L3 level. Specific cut-offs for SMI were calculated by receiver operator curve and divided by gender. Metabolic response was evaluated at end-of-treatment PET/CT, applying the Deauville score. Progression Free Survival (PFS) and Overall Survival (OS) were calculated for the whole population and for different subgroups, defined as per different sarcopenia cut-off levels. The specific cut-offs to define sarcopenia were 53 cm/m for male and 45.6 cm/m for female. Thirty-two (60%) patients were defined as sarcopenic. The 3-year and 5-year PFS rates were 29% and 23%, while the 3-year and 5-year OS rates were 43% and 33%. Metabolic response, total metabolic tumor volume (tMTV), total lesion glycolysis (tTLG) and sarcopenia were independent prognostic factors for PFS. Considering OS, no variable was significantly associated. Combination between PET features and sarcopenia may help to predict PFS.
这项回顾性研究的目的是分析和比较氟-18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（2-[F]-FDG PET/CT）特征与肌肉减少症在老年（≥65岁）套细胞淋巴瘤（MCL）患者中的预后作用，肌肉减少症通过PET的CT进行评估。我们招募了53例患者，这些患者接受了治疗前的2-[F]-FDG PET/CT和治疗结束时的PET/CT检查，并计算了主要的半定量参数。肌肉减少症通过骨骼肌指数（SMI，cm/m）进行测量，该指数由L3水平的低剂量PET/CT图像得出。通过受试者工作特征曲线计算SMI的特定临界值，并按性别进行划分。在治疗结束时的PET/CT上应用Deauville评分评估代谢反应。计算了整个人群以及根据不同肌肉减少症临界值水平定义的不同亚组的无进展生存期（PFS）和总生存期（OS）。定义肌肉减少症的特定临界值为男性53 cm/m，女性45.6 cm/m。32例（60%）患者被定义为肌肉减少症患者。3年和5年的PFS率分别为29%和23%，而3年和5年的OS率分别为43%和33%。代谢反应、总代谢肿瘤体积（tMTV）、总病变糖酵解（tTLG）和肌肉减少症是PFS的独立预后因素。考虑到OS，没有变量与之显著相关。PET特征与肌肉减少症的联合可能有助于预测PFS。
