Peters Helena A, Bärmann Ben-Niklas, Novruzov Emil, Weiss Daniel, Boschheidgen Matthias, Ivan Vivien Lorena, Liebers Nora, Fischer Johannes, Mamlins Eduards, Radujkovic Aleksandar, Kobbe Guido, Kirchner Julian, Minko Peter, Nachtkamp Kathrin, Jäger Paul, Antke Christina, Giesel Frederik L, Dietrich Sascha, Antoch Gerald, Jannusch Kai
Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf D-40225, Germany.
Department of Nuclear Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf D-40225, Germany.
Eur J Radiol Open. 2025 Jun 5;14:100663. doi: 10.1016/j.ejro.2025.100663. eCollection 2025 Jun.
The aim of this study is to evaluate the potential of [F]FDG-PET/CT in terms of prognostic value and treatment monitoring in relapsed / refractory diffuse large B-cell lymphoma (DLBCL)-patients treated with chimeric antigen receptor T-cell (CAR-T) therapy.
MATERIAL & METHODS: Forty-eight [F]FDG-PET/CT scans, acquired at pre-defined time points (t - t) of 18 DLBCL-patients (mean age: 60 ± 12 years) treated with CAR-T cell therapy were retrospectively enrolled. Median time of follow-up was ten months (IQR 6-16) following CAR-T cell infusion. SUV, sum of the product of diameters (SPD), Deauville score (DS) and Lugano classification (LC) were evaluated. Clinical parameters (age, sex) were obtained. Survival time analyses for progression-free survival (PFS) and overall survival (OS) were calculated, the latter by using the Kaplan-Meier method and Cox regression including a hazard ratio (HR). values below 0.05 were defined as statistically significant. 95 %-confidence intervals (CI) were calculated.
Patients with a SUV> 9.0 at t (median as threshold value) had a significantly shorter PFS ( = 0.04) and OS ( < 0.01). According to LC, a progressive disease (PD) at t ( = 0.02) and t ( < 0.01) was correlated with a reduced OS. SUV > 9.0 at t ( = 0.03, HR = 7.0, CI: 1.3-40.5) and DS > 3 at t ( = 0.04, HR = 8.2, CI: 1.1-61.3) were associated with an increased risk of a PD.
SUV of [F]FDG-PET/CT seems to be useful as a prognostic marker in DLBCL-patients undergoing CAR-T cell therapy. Furthermore, scores of clinical established Deauville classification and Lugano response criteria acquired at post-CAR-T [F]FDG-PET/CT might be an indicator for early therapy failure.
本研究旨在评估[F]FDG-PET/CT在接受嵌合抗原受体T细胞（CAR-T）治疗的复发/难治性弥漫性大B细胞淋巴瘤（DLBCL）患者的预后价值和治疗监测方面的潜力。
回顾性纳入18例接受CAR-T细胞治疗的DLBCL患者（平均年龄：60±12岁）在预先定义的时间点（t - t）进行的48次[F]FDG-PET/CT扫描。CAR-T细胞输注后的中位随访时间为10个月（IQR 6 - 16）。评估了SUV、直径乘积之和（SPD）、多维尔评分（DS）和卢加诺分类（LC）。获取了临床参数（年龄、性别）。计算了无进展生存期（PFS）和总生存期（OS）的生存时间分析，后者采用Kaplan-Meier方法和Cox回归并包括风险比（HR）。低于0.05的值被定义为具有统计学意义。计算了95%置信区间（CI）。
在t时SUV>9.0（中位数作为阈值）的患者PFS显著缩短（=0.04），OS也显著缩短（<0.01）。根据LC，在t时（=0.02）和t时（<0.01）的疾病进展（PD）与OS降低相关。在t时SUV>9.0（=0.03，HR = 7.0，CI：1.3 - 40.5）和在t时DS>3（=0.04，HR = 8.2，CI：1.1 - 61.3）与PD风险增加相关。
[F]FDG-PET/CT的SUV似乎可作为接受CAR-T细胞治疗的DLBCL患者的预后标志物。此外，CAR-T后[F]FDG-PET/CT获得的临床既定的多维尔分类和卢加诺反应标准评分可能是早期治疗失败的一个指标。
