Holter-Chakrabarty Jennifer, McNally Lacey, Levine John, Ferrara James, Vesely Sara K, Kanakry Christopher G, Garwe Tabitha, Han Zheng, Pandey Manu, Glover Joshua, Wen Yuejin, Gress Ron, Williams Kirsten M
From the Stephenson Cancer Center, University of Oklahoma Health Sciences Center, 800 NE 10th St, Oklahoma City, OK 73104 (J.H.C., L.M., S.K.V., Z.H., M.P., J.G., Y.W.); Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY (J.L., J.F.); Department of Biostatistics and Epidemiology, Hudson College of Public Health, The University of Oklahoma, Oklahoma City, Okla (S.K.V., T.G.); Experimental Transplantation and Immunotherapy Branch, National Cancer Institute, National Institutes of Health, Bethesda, Md (C.G.K., R.G.); Department of Biomedical Engineering, University of Central Oklahoma, Edmond, Okla (Z.H.); and Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Emory University, Atlanta, GA (K.M.W.).
Radiol Imaging Cancer. 2025 Jan;7(1):e240096. doi: 10.1148/rycan.240096.
Purpose To determine whether fluorine 18 (F) fluorothymidine (FLT) PET imaging alone or combined with Mount Sinai Acute GVHD International Consortium (MAGIC) biomarkers could help identify subclinical gastrointestinal graft versus host disease (GI-GVHD) by day 100 following hematopoietic stem cell transplantation (HSCT). Materials and Methods F-FLT PET imaging was analyzed in a prospective pilot study (ClinicalTrials.gov identifier no. NCT01338987) with a primary end point of engraftment for a planned secondary end point identifying GI-GVHD. Regions of interest (ROIs) in the colon (1 cm), jejunum (1 cm), and ileum (1 cm) were drawn in the area of greatest signal intensity within each segment of the GI tract by using software. Standardized uptake values (SUVs) were captured on day 28 following transplantation, along with MAGIC serum biomarkers and MAGIC algorithm probability (MAP) scores using MAGIC serum biomarkers collected at days 28-35. Results Among 20 participants (median age, 33.85 years [IQR: 28.65-39.25 years]; 11 female, nine male), seven presented with clinically diagnosed GI-GVHD by 100 days. Increased SUV was observed throughout the GI tract, most predominantly in the jejunum. Maximum and mean SUV by day 100 were significantly elevated in those with GI-GVHD (maximum SUV, 4.81; mean SUV, 3.73; = 7) compared with those without (maximum SUV, 3.99; mean SUV, 2.56). MAP score ( = .02) was associated with acute GVHD on day 28 but not on day 100. Spearman correlation between maximum SUV in the jejunum and MAP score was = 0.65 ( = .002). Conclusion These data suggest that F-FLT PET may help identify acute GI-GVHD after HSCT and could inform location in areas difficult to biopsy. Transplantation, PET/CT, Bone Marrow, Abdomen/GI ClinicalTrials.gov identifier: NCT01338987 © RSNA, 2024.
目的 确定单独使用氟-18（F）氟代胸腺嘧啶核苷（FLT）PET成像或联合西奈山急性移植物抗宿主病国际联盟（MAGIC）生物标志物，是否有助于在造血干细胞移植（HSCT）后第100天识别亚临床胃肠道移植物抗宿主病（GI-GVHD）。材料与方法 在一项前瞻性初步研究（ClinicalTrials.gov标识符：NCT01338987）中分析F-FLT PET成像，主要终点为植入，计划的次要终点为识别GI-GVHD。使用软件在胃肠道各段信号强度最大的区域绘制结肠（1 cm）、空肠（1 cm）和回肠（1 cm）的感兴趣区（ROI）。在移植后第28天采集标准化摄取值（SUV），同时采集MAGIC血清生物标志物，并使用在第28 - 35天收集的MAGIC血清生物标志物计算MAGIC算法概率（MAP）评分。结果 在20名参与者中（中位年龄33.85岁[四分位间距：28.65 - 39.25岁]；11名女性，9名男性），7名在100天内出现临床诊断的GI-GVHD。整个胃肠道均观察到SUV升高，最主要集中在空肠。与未发生GI-GVHD者相比，发生GI-GVHD者在第100天的最大SUV和平均SUV显著升高（最大SUV，4.81；平均SUV，3.73；n = 7）（未发生者最大SUV，3.99；平均SUV，2.56）。MAP评分在第28天与急性移植物抗宿主病相关（P = 0.02），但在第100天不相关。空肠最大SUV与MAP评分的Spearman相关性为r = 0.65（P = 0.002）。结论 这些数据表明，F-FLT PET可能有助于识别HSCT后的急性GI-GVHD，并可为难以活检部位的定位提供信息。移植、PET/CT、骨髓、腹部/胃肠道 ClinicalTrials.gov标识符：NCT01338987 © RSNA，2024
