Interim PET in Diffuse Large B-Cell Lymphoma

被引：25

作者：

Kurch, Lars ^{[1
]}

Huettmann, Andreas ^{[2
]}

Georgi, Thomas W. ^{[1
]}

Rekowski, Jan ^{[3
]}

Sabri, Osama ^{[1
]}

Schmitz, Christine ^{[2
]}

Kluge, Regine ^{[1
]}

Duehrsen, Ulrich ^{[2
]}

Hasenclever, Dirk ^{[4
]}

机构：

[1] Univ Klinikum Leipzig, Klin & Poliklin Nukl Med, Leipzig, Germany

[2] Univ Klinikum Essen, Klin Hamatol, Essen, Germany

[3] Univ Duisburg Essen, Inst Med Informat Biometrie & Epidemiol, Duisburg, Germany

[4] Univ Leipzig, Inst Med Informat Stat & Epidemiol, Leipzig, Germany

来源：

JOURNAL OF NUCLEAR MEDICINE | 2021年 / 62卷 / 08期

基金：

芬兰科学院;

关键词：

diffuse large B-cell lymphoma; PET; interim evaluation; Deauville scale; DSUVmax; qPET; PETAL trial; EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY; NON-HODGKIN-LYMPHOMA; SUV-BASED ASSESSMENT; EARLY F-18-FDG PET; FDG-PET; RESPONSE ASSESSMENT; PROGNOSTIC VALUE; CHEMOTHERAPY; SCANS; RECOMMENDATIONS;

D O I：

10.2967/jnumed.120.255034

中图分类号：

R8 [特种医学]; R445 [影像诊断学];

学科分类号：

1002 ; 100207 ; 1009 ;

摘要：

In diffuse large B-cell lymphoma, early assessment of treatment response by F-18-FDG PET may trigger treatment modification. Reliable identification of good and poor responders is important. We compared 3 competing methods of interim PET evaluation. Methods: Images from 449 patients participating in the "PET-Guided Therapy of Aggressive Non-Hodgkin Lymphomas" trial were reanalyzed by applying the visual Deauville score and the SUV-based qPET (q = quantitative) and Delta SUVmax scales to interim PET scans performed after 2 cycles of chemotherapy. qPET relates residual lymphoma F-18-FDG uptake to physiologic liver uptake, converting the ordinal Deauville scale into a continuous scale and permitting a direct comparison with the continuous Delta SUVmax scale, which is based on SUVmax changes between baseline and interim scans. Positive and negative predictive values were calculated for progression-free survival. Results: When established thresholds were used to distinguish between good and poor responders (visual Deauville score 1-3 vs. 4-5; Delta SUVmax > 66% vs. <= 66%), the positive predictive value was significantly lower with Deauville than Delta SUVmax (38.4% vs. 56.6%; P = 0.03). qPET and Delta SUVmax were strongly correlated on the log scale (Pearson r = 0.75). When plotted along corresponding percentiles, the positive predictive value curves for qPET and Delta SUVmax were superimposable, with low values up to the 85th percentile and a steep rise thereafter. The recommended threshold of 66% SUVmax reduction for the identification of poor responders was equivalent to qPET = 2.26, corresponding to score 5 on the visual Deauville scale. The negative predictive value curves were also superimposable but remained flat between 80% and 70%. Conclusion: Continuous scales are better suited for interim PET-based outcome prediction than the ordinal Deauville scale. qPET and Delta SUVmax essentially carry the same information. The proportion of poor-risk patients identified is less than 15%.

引用

页码：1068 / 1074

页数：7

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