三B级滤泡性淋巴瘤的半定量PET特征和治疗终点PET的价值
The value of semiquantitative PET features and end-of-therapy PET in grade 3B follicular lymphoma
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影响因子:3.8
分区:医学2区 / 血液学2区
发表日期:2024 Dec
作者:
Allison Barraclough, Sze Ting Lee, Diego Villa, Greg Hapgood, Don Wilson, Geoffrey Chong, Eliza A Hawkes
DOI:
10.1111/bjh.19823
摘要
三级滤泡性淋巴瘤（G3BFL）是一种罕见的淋巴瘤，认为位于低级别滤泡性淋巴瘤（FL）和弥漫性大B细胞淋巴瘤（DLBCL）之间的连续体中。量化正电子发射断层扫描（PET）指标如总代谢肿瘤负荷（TMTV）、总病灶糖酵解（TLG）和最大标准摄取值（SUVmax）在FL和DLBCL中已被广泛分析，但G3BFL的相关数据尚缺乏。本研究描述了在46例G3BFL病例中的PET结果和放射组学特征，这些病例均接受了类似R-CHOP的化疗。采用MIM软件对PET的TMTV、TLG和SUVmax进行了中心半自动分析，并与临床结局进行相关分析，并与低级别FL和DLBCL的已发表结果进行比较。在G3BFL中，治疗结束时的完全代谢反应与改善的无进展生存期（PFS；p=0.002）和总生存期（OS；p=0.04）有关。G3BFL的中位TLG（1455）和SUVmax（16.50）位于已发表的低级别FL（TLG：1112，SUVmax：11.3）和DLBCL（TLG：3004，SUVmax：24.35）之间。未观察到TMTV（>350 cm3）与生存相关（PFS：p=0.24；OS：p=0.40）。高SUVmax（>19.2）和TLG（>2760）均显示出较差的PFS，但对OS无显著影响（PFS：SUVmax p=0.004；TLG p=0.05）。这些数据支持在G3BFL的基线和治疗反应评估中常规应用PET放射组学分析。
Abstract
Grade 3B follicular lymphoma (G3BFL) is a rare lymphoma thought to sit on a continuum between low-grade FL and diffuse large B-cell lymphoma (DLBCL). The prognostic impact of quantitative positron emission tomography (PET) metrics such as total metabolic tumour volume (TMTV), total lesion glycolysis (TLG), and maximum standard uptake value (SUVmax) have been extensively analysed in FL and DLBCL, but G3BFL data are lacking. Here, we describe PET outcomes and radiomic characteristics in 46 G3BFL cases uniformly treated with R-CHOP (like) chemotherapy. Central semi-automated PET TMTV, TLG, and SUVmax analyses, using MIM software, were correlated with clinical outcomes and compared with published results in low-grade FL and DLBCL. In G3BFL, the end-of-treatment complete metabolic response was associated with improved progression-free survival (PFS; p = 0.002) and overall survival (OS; p = 0.04). G3BFL median TLG (1455) and SUVmax (16.50) sit between published values for low-grade FL (TLG: 1112, SUVmax: 11.3) and DLBCL (TLG: 3004, SUVmax: 24.35). No association between TMTV (>350 cm3) and survival was seen (PFS: p = 0.24; OS: p = 0.40). High SUVmax (>19.2) and TLG (>2760) both conferred inferior PFS but not OS (PFS: SUVmax p = 0.004; TLG p = 0.05). These data support the routine incorporation of PET radiomics at baseline and treatment response for G3BFL.