Li Jian-Ping, Wang Pei, Liu Fu-Fu, Wu Min, Deng Kan, Wang Xin-Kai, Wu Yong
Department of PET-CT Imaging Diagnosis, Shanghai Tianyou Hospital, Shanghai, China.
PLA Navy Specialty Medical Center, Shanghai, China.
Medicine (Baltimore). 2025 Sep 5;104(36):e44067. doi: 10.1097/MD.0000000000044067.
Diffuse large B-cell lymphoma (DLBCL) requires accurate therapeutic response assessment. This study evaluates the efficacy and prognostic value of [18F] fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) using the Deauville 5-point scale and maximum standardized uptake value (ΔSUVmax) methods in DLBCL patients. A retrospective study was conducted from January 2021 to December 2022, including 60 DLBCL patients. Patients underwent baseline and interim PET/CT scans during chemotherapy, treated with the R-CHOP regimen. The Deauville 5-point scale visually assessed PET/CT results, while the ΔSUVmax method calculated the percentage change in SUVmax. Consistency with the Lugano criteria was evaluated using the Kappa statistic. Statistical analyses were performed with SPSS software (version 27.0, Chicago). Following 3 to 4 cycles of R-CHOP, 70.0% of patients achieved complete response, decreasing to 58.3% at 12 months. The Deauville 5-point scale classified 78.3% of patients as negative and 21.7% as positive, with moderate agreement with Lugano criteria (Kappa = 0.568, P < .01). The ΔSUVmax method identified 68.3% of patients as negative and 31.7% as positive, showing substantial agreement with Lugano criteria (Kappa = 0.728, P < .001). The ΔSUVmax method demonstrated higher sensitivity (81.33%), specificity (92.33%), negative predictive value (92.33%), positive predictive value (81.33%), and accuracy (90.68%). Both the Deauville 5-point scale and ΔSUVmax method are effective for evaluating interim therapeutic response and predicting 12-month outcomes in DLBCL patients. The ΔSUVmax method showed higher accuracy and predictive value. Integrating these methods into clinical practice can enhance patient prognosis and optimize treatment strategies.
弥漫性大B细胞淋巴瘤(DLBCL)需要准确评估治疗反应。本研究使用多维尔5分制和最大标准化摄取值(ΔSUVmax)方法评估[18F]氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描(18F-FDG PET-CT)在DLBCL患者中的疗效和预后价值。对2021年1月至2022年12月期间的60例DLBCL患者进行了一项回顾性研究。患者在化疗期间接受基线和中期PET/CT扫描,采用R-CHOP方案治疗。多维尔5分制通过视觉评估PET/CT结果,而ΔSUVmax方法计算SUVmax的百分比变化。使用Kappa统计量评估与卢加诺标准的一致性。使用SPSS软件(版本27.0,芝加哥)进行统计分析。经过3至4个周期的R-CHOP治疗后,70.0%的患者达到完全缓解,12个月时降至58.3%。多维尔5分制将78.3%的患者分类为阴性,21.7%为阳性,与卢加诺标准具有中等一致性(Kappa = 0.568,P < 0.01)。ΔSUVmax方法将68.3%的患者分类为阴性,31.7%为阳性,与卢加诺标准具有高度一致性(Kappa = 0.728,P < 0.001)。ΔSUVmax方法显示出更高的敏感性(81.33%)、特异性(92.33%)、阴性预测值(92.33%)、阳性预测值(81.33%)和准确性(90.68%)。多维尔5分制和ΔSUVmax方法在评估DLBCL患者的中期治疗反应和预测12个月结局方面均有效。ΔSUVmax方法显示出更高的准确性和预测价值。将这些方法整合到临床实践中可以改善患者预后并优化治疗策略。