Kotur Milica, Pantić Nikola, Grozdić Milojević Isidora, Mehmedović Amin, Andrejić Nikola, Stojiljković Milica, Petrović Jelena, Šobić Šaranović Dragana, Artiko Vera, Odalović Strahinja
Center for Nuclear Medicine with PET, University Clinical Center of Serbia, Belgrade, Serbia.
Hell J Nucl Med. 2025 May-Aug;28(2):115-123. doi: 10.1967/s002449912802. Epub 2025 Aug 4.
The aim of this study is to determine the importance of different fluorine-18-fluorodeoxyglucose (F-FDG) positron emission tomography with computed tomography (PET/CT) semi-quantitative and quantitative parameters, as well as various clinical and demographic parameters, in predicting disease outcomes and response to therapy in patients with diffuse large B-cell lymphoma (DLBCL).
The study included 64 patients diagnosed with DLBCL who underwent F-FDG PET/CT imaging between January 2020 and April 2023. Each patient underwent both an initial F-FDG PET/CT and an interim F-FDG PET/CT after 2 or 4 cycles of chemotherapy. The Deauville score (DS) was calculated for each patient. Progression-free survival (PFS) was defined as the time from the date of diagnosis to the first appearance of metabolic or morphological progression of pre-existing lesions and/or the appearance of new lesions detected on interim F-FDG PET/CT or follow-up radiological imaging, as well as in cases of death due to the underlying disease or until the end of the clinical follow-up period.
Among the clinical-demographic parameters analyzed, the only significant predictive factor was the international prognostic index (IPI) score, categorized by group. Of the F-FDG PET/CT parameters examined, DS showed strong statistical significance in both univariate and multivariate analyses. While maximum standardized uptake value (SUVmax) and peak SUV (SUVpeak) were statistically significant in the univariate analysis. Progression-free survival was longer in patients with an IPI ≤2 and DS ≤3, compared to those with higher IPI and DS.
The results of this study showed that the early metabolic response to therapy assessed on the basis of interim F-FDG PET/CT is a significant independent predictive factor for disease outcome in patients with DLBCL.
本研究旨在确定不同的氟-18-氟脱氧葡萄糖（F-FDG）正电子发射断层扫描与计算机断层扫描（PET/CT）半定量和定量参数，以及各种临床和人口统计学参数，在预测弥漫性大B细胞淋巴瘤（DLBCL）患者的疾病转归和治疗反应中的重要性。
本研究纳入了64例在2020年1月至2023年4月期间接受F-FDG PET/CT成像的DLBCL诊断患者。每位患者在化疗2或4个周期后均接受了初始F-FDG PET/CT和中期F-FDG PET/CT检查。计算每位患者的多维尔评分（DS）。无进展生存期（PFS）定义为从诊断日期到先前存在病变的代谢或形态学进展首次出现和/或中期F-FDG PET/CT或后续放射学成像检测到新病变出现的时间，以及因基础疾病死亡或直至临床随访期结束的时间。
在分析的临床人口统计学参数中，唯一显著的预测因素是按组分类的国际预后指数（IPI）评分。在所检查的F-FDG PET/CT参数中，DS在单变量和多变量分析中均显示出强烈的统计学意义。而最大标准化摄取值（SUVmax）和峰值SUV（SUVpeak）在单变量分析中具有统计学意义。与IPI和DS较高的患者相比，IPI≤2且DS≤3的患者无进展生存期更长。
本研究结果表明，基于中期F-FDG PET/CT评估的早期治疗代谢反应是DLBCL患者疾病转归的重要独立预测因素。
