Yu Congcong, Wang Jing, Chen Lin, Zhou Rui, Dou Xiaofeng, Tian Mei, Zhang Hong, Zhang Xiaohui, Jin Chentao
Department of Nuclear Medicine and Medical PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Department of Nuclear Medicine, Hangzhou Institute of Medicine, Zhejiang Cancer Hospital, Chinese Academy of Sciences, Hangzhou, Zhejiang, China.
Eur J Nucl Med Mol Imaging. 2025 Sep 19. doi: 10.1007/s00259-025-07561-z.
To investigate the prognostic values of 2-deoxy-2-[F]fluoro-D-glucose positron emission tomography/computed tomography ([F]FDG PET/CT) in patients with diffuse large B-cell lymphoma (DLBCL) treated with Polatuzumab vedotin (Pola)-containing regimens.
Thirty-nine patients who received Pola-containing regimens and underwent pre-treatment [F]FDG PET/CT were retrospectively enrolled and followed up. Qualitative response was assessed using Lugano criteria on follow up PET. Quantitative [F]FDG PET parameters including maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were evaluated using two segmentation methods (SUV 4.0 and 41% SUVmax), and changes in these indices (Δvalues) between pre-Pola and first follow-up PET scans were calculated. The prognostic values of PET metabolic parameters, clinical characteristics, and laboratory indicators were evaluated using time-dependent receiver operating characteristic (ROC) curve, and Cox regression analysis. Survival functions were estimated by Kaplan-Meier analysis.
The median follow-up duration was 17.2 months (range 3.28 months - 26.2 months). During this period, 16 patients (41.0%) experienced progression. Patients with complete metabolic responses (CMR) exhibited superior outcomes than patients with partial metabolic responses (PMR). ROC and Cox analysis demonstrated that MTV and TLG based on SUV 4.0 segmentation showed superior predictive performance than those based on the 41% SUVmax method. Multivariate Cox regression analysis identified SUVmean (P = 0.016, HR = 1.27) and MTV (P = 0.002, HR = 1.01) on first follow-up PET as independent predictors of progression-free survival (PFS).
CMR patients exhibited superior outcomes than PMR patients, and SUVmean and MTV on the first follow-up PET were independent predictors of PFS, suggesting that [F]FDG PET/CT may play an important role in predicting outcomes of DLBCL patients treated with Pola-containing regimens.
探讨2-脱氧-2-[F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描（[F]FDG PET/CT）在接受含泊洛妥珠单抗（Pola）方案治疗的弥漫性大B细胞淋巴瘤（DLBCL）患者中的预后价值。
回顾性纳入39例接受含Pola方案治疗并在治疗前接受[F]FDG PET/CT检查的患者并进行随访。在随访PET上使用卢加诺标准评估定性反应。使用两种分割方法（SUV 4.0和41%SUVmax）评估包括最大标准化摄取值（SUVmax）、平均标准化摄取值（SUVmean）代谢肿瘤体积（MTV）和总病变糖酵解（TLG）在内的定量[F]FDG PET参数，并计算Pola治疗前与首次随访PET扫描之间这些指标的变化（Δ值）。使用时间依赖性受试者操作特征（ROC）曲线和Cox回归分析评估PET代谢参数、临床特征和实验室指标的预后价值。通过Kaplan-Meier分析估计生存函数。
中位随访时间为17.2个月（范围3.28个月至26.2个月）。在此期间，16例患者（41.0%）出现疾病进展。完全代谢缓解（CMR）的患者比部分代谢缓解（PMR）的患者表现出更好的预后。ROC和Cox分析表明，基于SUV 4.0分割的MTV和TLG比基于41%SUVmax方法的具有更好的预测性能。多变量Cox回归分析确定首次随访PET上的SUVmean（P = 0.016，HR = 1.27）和MTV（P = 0.002，HR = 1.01）是无进展生存期（PFS）的独立预测因素。
CMR患者比PMR患者表现出更好的预后，首次随访PET上的SUVmean和MTV是PFS的独立预测因素，这表明[F]FDG PET/CT可能在预测接受含Pola方案治疗的DLBCL患者的预后中发挥重要作用。
