在评估连续的氟代脱氧葡萄糖正电子发射断层扫描时，结合基线代谢肿瘤体积和北京标准对弥漫性大B细胞淋巴瘤进行风险评估。
Risk Assessment in Diffuse Large B-Cell Lymphoma by Combining Baseline Metabolic Tumor Volume and Peking Criteria When Evaluating Series F-Fluorodeoxyglucose Positron Emission Tomography Scans.
作者信息
Yuan Tingting, Zhang Yuewei, Chen Xuetao, Wei Maomao, Zhu Hua, Song Yuqin, Yang Zhi, Zhu Jun, Wang Xuejuan
机构信息
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital and Institute, Beijing, China.
Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China.
出版信息
Front Oncol. 2022 Apr 21;12:876581. doi: 10.3389/fonc.2022.876581. eCollection 2022.
UNLABELLED
This study aimed to determine the predictive and prognostic value of baseline metabolic tumor volume (MTV) and the Peking criteria from serial positron emission tomography (PET) scans in diffuse large B-cell lymphoma, including 300 newly diagnosed patients who were prospectively treated with 2-4 cycles of standard first-line treatment (). PET/computed tomography (CT) examinations were performed at baseline, after two (PET-2) or four cycles (PET-4). PET during the interim was evaluated using Deauville 5-point scales (5-PS), ΔSUV criteria, and the Peking criteria which interpreted based on the maximum standard uptake of the liver (SUV). Peking criteria had better accuracy, positive predictive value (PPV), and specificity than other two methods. The MTV and Peking criteria both significantly predicted progression-free survival (PFS) and overall survival (OS). An MTV > 191 cm and Peking criteria of PET-2 and PET-4 > 1.6-fold SUV was used as the cutoff for a positive result. PET-4 achieved higher accuracy, PPV, and specificity for 2-year PFS (83.3%, 86.7%, and 98.4%, respectively) and OS (92.6%, 73.3%, and 97.2%, respectively) than PET-2. Various prognostic models containing different risk factors were established Cox regression analysis. The MTV and PET-2/PET-4 results were used to categorized patients into low-risk, intermediate-risk, and high-risk prognostic groups (with 0, 1, and 2 risk factors, respectively) ( < 0.0001). High burden MTV and positive PET-2 and PET-4 (>1.6-fold SUV) could identify high-risk patients with 2-year PFS and OS of 0.0% and 26.3% (95% confidence interval [CI]: N/A to 54.3%). When PET-2 and PET-4 were evaluated by 5-PS, the 2-year PFS and OS from high risk patients of three-parameters model achieved 31.4% (95%CI: 6.9%-55.9%) and 42.7% (95%CI: 14.6%-70.7%). In conclusion, combining baseline MTV and any regular response on PET/CT evaluated using the Peking criteria can improve prognostic value. Serial PET/CT from baseline MTV to PET-4 may have relatively greater predictive power for poor prognosis in diffuse large B-cell lymphoma.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov, identifier (NCT02928861).
未标注
本研究旨在确定基线代谢肿瘤体积（MTV）和来自系列正电子发射断层扫描（PET）的北京标准在弥漫性大B细胞淋巴瘤中的预测和预后价值，纳入300例新诊断患者，他们接受了2 - 4周期的标准一线治疗（）。在基线、两周期（PET - 2）或四周期（PET - 4）治疗后进行PET/计算机断层扫描（CT）检查。中期PET使用多维尔5分制（5 - PS）、ΔSUV标准和基于肝脏最大标准摄取值（SUV）解释的北京标准进行评估。北京标准比其他两种方法具有更好的准确性、阳性预测值（PPV）和特异性。MTV和北京标准均显著预测无进展生存期（PFS）和总生存期（OS）。MTV > 191 cm以及PET - 2和PET - 4的北京标准> 1.6倍SUV被用作阳性结果的截断值。PET - 4在2年PFS（分别为83.3%、86.7%和98.4%）和OS（分别为92.6%、73.3%和97.2%）方面比PET - 2具有更高的准确性、PPV和特异性。通过Cox回归分析建立了包含不同危险因素的各种预后模型。MTV和PET - 2/PET - 4结果用于将患者分为低风险、中风险和高风险预后组（分别有0、1和2个危险因素）（< 0.0001）。高负荷MTV以及PET - 2和PET - 4阳性（> 1.6倍SUV）可识别2年PFS和OS分别为0.0%和26.3%（95%置信区间[CI]：无数据至54.3%）的高风险患者。当通过多维尔5分制评估PET - 2和PET - 4时，三参数模型中高风险患者的2年PFS和OS分别达到31.4%（95%CI：6.9% - 55.9%）和42.7%（95%CI：14.6% - 70.7%）。总之，结合基线MTV和使用北京标准评估的PET/CT上的任何常规反应可提高预后价值。从基线MTV到PET - 4的系列PET/CT对弥漫性大B细胞淋巴瘤的不良预后可能具有相对更大的预测能力。
临床试验注册
ClinicalTrials.gov，标识符（NCT02928861）。
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