Albano Domenico, Ravanelli Marco, Durmo Rexhep, Versari Annibale, Filice Angelina, Rizzo Alessio, Racca Manuela, Pizzuto Daniele Antonio, Bertagna Francesco, Annunziata Salvatore
Nuclear Medicine Unit, ASST Spedali Civili of Brescia, Brescia, Italy.
Department of Nuclear Medicine, University of Brescia, Brescia, Italy.
Front Med (Lausanne). 2024 Dec 18;11:1515040. doi: 10.3389/fmed.2024.1515040. eCollection 2024.
2-deoxy-2-[F]-fluoro-D-glucose (2-[F]FDG) positron emission tomography/computed tomography (PET/CT) plays a crucial role in the management of lymphoma in different settings, such as staging disease, assessing response to therapy, predicting prognosis, and planning RT. Beside visual analysis, several semiquantitative parameters were introduced to study lymphoma with promising results. These parameters can represent different disease characteristics, like body composition (such as sarcopenic index), dissemination of disease (Dmax), tumor burden (including metabolic tumor volume) and texture features. All these parameters showed promising results, especially in terms of prognosis (progression free survival and overall survival), but lack of standardization and shared methodology remains a big issue. Advances in PET-based biomarkers are on the horizon, yet their integration into clinical decision-making is currently hindered by methodological limitations that require resolution through confirmatory prospective validation in specific patient groups. This review highlights studies demonstrating the prognostic and predictive value of these semiquantitative parameters in lymphoma, while also discussing their potential applicability in clinical practice.
2-脱氧-2-[F]-氟-D-葡萄糖(2-[F]FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)在淋巴瘤的不同治疗环节中发挥着关键作用,如疾病分期、评估治疗反应、预测预后以及放疗规划。除了视觉分析外,还引入了多个半定量参数来研究淋巴瘤,取得了不错的结果。这些参数可以代表不同的疾病特征,如身体组成(如肌肉减少指数)、疾病播散(Dmax)、肿瘤负荷(包括代谢肿瘤体积)和纹理特征。所有这些参数都显示出良好的结果,特别是在预后(无进展生存期和总生存期)方面,但缺乏标准化和统一的方法仍然是一个大问题。基于PET的生物标志物的进展即将出现,然而目前它们在临床决策中的整合受到方法学限制的阻碍,需要通过在特定患者群体中的验证性前瞻性研究来解决。本综述重点介绍了一些研究,这些研究证明了这些半定量参数在淋巴瘤中的预后和预测价值,同时也讨论了它们在临床实践中的潜在适用性。