关键词:
FDG PET
CT
Diffuse large B-cell lymphoma
Metabolic tumour volume
Prognosis
摘要:
PurposeThe purpose of this study was to determine the prognostic value of metabolic volumetric parameters as a quantitative index on pre-treatment F-18-FDG PET/CT in addition to the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) in patients with diffuse large B-cell lymphoma (DLBCL).MethodsA total of 103 consecutive patients with DLBCL and baseline FDG PET/CT were retrospectively evaluated. Quantitative metabolic parameters, including total metabolic tumour volume (TMTV) using a standardized uptake value (SUV) of 2.5 as the threshold, were estimated. Receiver operating characteristic curve analysis was used to determine the optimal cut-off values for the metabolic parameters. The relationships between study variables and patient survival were tested using Cox regression analysis. Patient survival rates were derived from Kaplan-Meier curves and compared using the log-rank *** follow-up was 34months. In patients with a low TMTV (<249cm(3)), the 3-year progression free survival (PFS) rate was 83% and the overall survival (OS) rate was 92%, in contrast to 41% and 57%, respectively, in those with a high TMTV (249cm(3)). In univariate analysis, a high TMTV and NCCN-IPI 4 were associated with inferior PFS and OS (P<0.0001 for all), as was a high total lesion glycolysis (P=0.004 and P=0.005, respectively). In multivariate analysis, TMTV and NCCN-IPI were independent predictors of PFS (hazard ratio, HR, 3.11, 95% confidence interval, CI, 1.37-7.07, P=0.007, and HR 3.42, 95% CI 1.36-8.59, P=0.009, respectively) and OS (HR 3.41, 95% CI 1.24-9.38, P=0.017, and HR 5.06, 95% CI 1.46-17.60, P=0.014, respectively). TMTV was able to separate patients with a high-risk NCCN-IPI of 4 (n=62) into two groups with significantly different outcomes;patients with low TMTV (n=16) had a 3-year PFS rate of 75% and an OS rate of 88%, while those with a high TMTV had a 3-year PFS rate of 32% and an OS rate of 47% ((2)=7.92, P=0.005, and (2)=8.26, P=