Prognostic value of interim and end-of-treatment 18F-FDG PET/CT in patients with diffuse large B-cell lymphoma / 中华核医学与分子影像杂志

ABSTRACT

Objective To compare the value of interim and end-of-treatment 18F-fluorodeoxyglucose (FDG) PET/CT for the prognosis of patients with diffuse large B-cell lymphoma (DLBCL).Methods A total of 116 DLBCL patients (male ∶female=1 ∶ 1.32,average age:(57.87± 15.89) years) whose initial treatment was rituximab+cyclophosphamide+doxorubicin+vincristine+prednisone(R-CHOP),were enrolled from 2008 to 2016.All patients underwent pre-treatment,interim and end-of-treatment 18F-FDG PET/CT.End points were progression-free survival (PFS) and overall survival (OS).Correlation between metabolic parameters including maximum standardized uptake value (SUVmax),metabolic tumor volume (MTV),total lesion glycolysis (TLG),Deauville score (DS),△SUVmax,△MTV,△TLG in the interim PET/CT and those in the end-of-treatment PET/CT was analyzed with Pearson correlation analysis.The ability of metabolic parameters to assess the prognosis was evaluated by receiver operating characteristic(ROC) curve analysis.The survival was analyzed by Kaplan-Meier method and hazard ratio (HR) was calculated by Cox regression model.Results The r values for △SUVmax,△MTV,△TLG of interim and end-of-treatment PET/CT were 0.630,0.912,0.955,respectively (all P＜0.01).One hundred and four cases (89.7％,104/116)had the same DS in the interim and end-of-treatment PET/CT,and the r value for DS between two PET/CT scans was 0.733 (P＜0.01).The interim metabolic parameters were superior to that at the end of treatment in evaluating the progression.The 5-year PFS (83.1％ vs 35.9％,P＜0.01;HR =5.969,P＜0.01) and OS (95.7％ vs 75.5％,P＜0.01;HR=8.161,P＜0.05) rates were significantly higher in DS 1-3 group than those in DS 4-5 group.Conclusions Interim PET/CT is effective for the prediction of prognosis in DLBCL patients with R-CHOP treatment.Patients with complete remission in the interim can omit the end-of-treatment PET/CT.