Peters Helena A, Novruzov Emil, Bärmann Ben-Niklas, 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, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, D-40225 Düsseldorf, Germany.
Department of Nuclear Medicine, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, D-40225 Düsseldorf, Germany.
Diagnostics (Basel). 2025 Aug 13;15(16):2025. doi: 10.3390/diagnostics15162025.
: Evaluation of the predictive potential of pre-CAR-T [F]FDG PET/CT in Diffuse Large B-Cell Lymphoma (DLBCL) patients concerning Cytokine Release Syndrome (CRS) and Immune Effector Cell-associated Neurotoxicity Syndrome (ICANS). : Eighteen DLBCL patients (mean age: 60 ± 12 years) who underwent pre-therapeutic [F]FDG-PET/CT and CAR-T cell therapy were retrospectively included. Median follow-up time was ten months (IQR6-16) after CAR-T cell infusion. Age, sex, serum lactate dehydrogenase (LDH), interleukin-6 (IL-6), C-reactive protein (CRP), and modified Endothelial Activation and Stress Index (mEASIX) were obtained. Potential occurrence of CRS/ICANS and the SUV were evaluated. Pearson and Spearman correlations, group comparisons (Mann-Whitney U-test) and the odds ratio (OR) were calculated. P values below 0.05 were defined as statistically significant and 95%-confidence intervals (CI) were calculated. : Pre-therapeutic SUV correlated positively with LDH (r = 0.5; = 0.02), with the grade of CRS (r = 0.5; = 0.03) and with the grade of ICANS (r = 0.6; = 0.01). Appearance of ICANS was significantly correlated with pre-therapeutic SUV ( = 0.03; U = 7.0; Z = -2.2). Using ROC analysis and Youden's index, an SUV threshold of 17 (AUC: 0.865; < 0.01) was defined. Patients exceeding a pre-therapeutic SUV of 17 had a significantly higher risk of CRS grade > 1 (OR = 22; CI 2, 314; = 0.03) and ICANS grade > 1 (OR = 18; CI 1, 271; = 0.04). : Pre-therapeutic SUV may be a useful marker for identifying DLBCL patients at risk for CRS and ICANS.
评估治疗前[F]FDG PET/CT对弥漫性大B细胞淋巴瘤（DLBCL）患者细胞因子释放综合征（CRS）和免疫效应细胞相关神经毒性综合征（ICANS）的预测潜力。：回顾性纳入18例接受治疗前[F]FDG-PET/CT和CAR-T细胞治疗的DLBCL患者（平均年龄：60±12岁）。CAR-T细胞输注后中位随访时间为10个月（IQR 6-16）。获取年龄、性别、血清乳酸脱氢酶（LDH）、白细胞介素-6（IL-6）、C反应蛋白（CRP）和改良内皮激活与应激指数（mEASIX）。评估CRS/ICANS的潜在发生情况和SUV。计算Pearson和Spearman相关性、组间比较（Mann-Whitney U检验）和比值比（OR）。P值低于0.05被定义为具有统计学意义，并计算95%置信区间（CI）。：治疗前SUV与LDH呈正相关（r = 0.5；P = 0.02），与CRS分级呈正相关（r = 0.5；P = 0.03），与ICANS分级呈正相关（r = 0.6；P = 0.01）。ICANS的出现与治疗前SUV显著相关（P = 0.03；U = 7.0；Z = -2.2）。使用ROC分析和尤登指数，定义SUV阈值为17（AUC：0.865；P < 0.01）。治疗前SUV超过17的患者发生CRS分级>1（OR = 22；CI 2，314；P = 0.03）和ICANS分级>1（OR = 18；CI 1，271；P = 0.04）的风险显著更高。：治疗前SUV可能是识别有CRS和ICANS风险的DLBCL患者的有用标志物。
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