治疗前 F-FDG PET/CT 预测 IgG4 相关疾病患者疾病复发的前瞻性研究。

Pretherapy F-FDG PET/CT in Predicting Disease Relapse in Patients With Immunoglobulin G4-Related Disease: A Prospective Study.

机构信息

Department of Nuclear Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.

Institute of Environmental and Occupational Health Sciences, National Taiwan University, Taipei, Taiwan.

出版信息

Korean J Radiol. 2023 Jun;24(6):590-598. doi: 10.3348/kjr.2022.0576.

DOI:10.3348/kjr.2022.0576

PMID:37271212

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10248362/

Abstract

OBJECTIVE

To investigate whether the levels of inflammation detected by F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) can predict disease relapse in immunoglobulin G4-related disease (IgG4-RD) patients receiving standard induction steroid therapy.

MATERIALS AND METHODS

This prospective study analyzed pretherapy FDG PET/CT images from 48 patients (mean age, 63 ± 12.9 years; 45 males and 3 females) diagnosed with IgG4-RD between September 2008 and February 2018, who subsequently received standard induction steroid therapy as the first-line treatment. Multivariable Cox proportional hazards models were used to identify the potential prognostic factors associated with relapse-free survival (RFS).

RESULTS

The median follow-up time for the entire cohort was 1913 days (interquartile range [IQR], 803-2929 days). Relapse occurred in 81.3% (39/48) patients during the follow-up period. The median time to relapse was 210 days (IQR, 140-308 days) after completion of standardized induction steroid therapy. Among the 17 parameters analyzed, Cox proportional hazard analysis identified whole-body total lesion glycolysis (WTLG) > 600 on FDG-PET as an independent risk factor for disease relapse (median RFS, 175 vs. 308 days; adjusted hazard ratio, 2.196 [95% confidence interval: 1.080-4.374]; = 0.030).

CONCLUSION

WTLG on pretherapy FDG PET/CT was the only significant factor associated with RFS in IgG-RD patients receiving standard steroid induction therapy.

摘要

目的

探讨 F-氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）检测到的炎症水平是否可以预测接受标准诱导性类固醇治疗的 IgG4 相关疾病（IgG4-RD）患者的疾病复发。

材料和方法

本前瞻性研究分析了 2008 年 9 月至 2018 年 2 月期间诊断为 IgG4-RD 的 48 例患者（平均年龄 63 ± 12.9 岁；45 名男性和 3 名女性）的治疗前 FDG PET/CT 图像，这些患者随后接受标准诱导性类固醇治疗作为一线治疗。多变量 Cox 比例风险模型用于确定与无复发生存（RFS）相关的潜在预后因素。

结果

整个队列的中位随访时间为 1913 天（四分位距[IQR]，803-2929 天）。在随访期间，81.3%（39/48）的患者发生复发。完成标准化诱导性类固醇治疗后，复发的中位时间为 210 天（IQR，140-308 天）。在分析的 17 个参数中，Cox 比例风险分析确定 FDG-PET 上的全身总病变糖酵解（WTLG）>600 是疾病复发的独立危险因素（中位 RFS，175 与 308 天；调整后的危险比，2.196[95%置信区间：1.080-4.374]；P=0.030）。