化疗早期及中期(18)F-FDG PET/CT显像对56例弥漫大B细胞淋巴瘤患者预后的评估价值

OBJECTIVE: To investigate the prognosis value of early and interim (18)F-FDG-PET/CT scan in patients with diffuse large B-cell lymphoma (DLBCL) to establish the suitable criteria for evaluating posttherapeutic lesions in scans. METHODS: Fifty-six newly diagnosed DLBCL patients were enrolled in the study, and underwent baseline, early and interim (18)F-FDG PET/CT scans. Five-point and % ΔSUV(max) criteria were used separately to interpret (18)F-FDG PET/CT images. Interobserver reproducibility was assessed with the kappa test (κ), and thresholds of % ΔSUV(max) were calculated via receiver operating characteristic curve (ROC). Survival curves were obtained using Kaplan-Meier curves and log-rank test. Cox regression analysis was used for multi-factor analysis. RESULTS: Median follow-up was 24 months (6 to 42 months). The kappa value of the five-point scale was above 0.600 with the reference background set in the liver (Score≥4). The optimal threshold of % ΔSUV(max) was 81% for early PET/CT and 74% for interim PET/CT. Survival analysis showed both early and interim PET/CT scans could predict the outcome of 56 patients with DLBCL, and 3-year PFS and OS of PET-negative patients were significantly higher than those of PET-positive ones (P<0.05). Five-score criteria were more accurate in evaluating 3-year PFS of DLBCL patients in the interim PET/CT scan (76.79%). % ΔSUV(max) criteria were better for interpreting 3-year OS (76.79% and 83.93%). Multi-factor analysis demonstrated that early and interim PET/CT were solid predicting factors for DLBCL patients. CONCLUSION: Early and interim PET/CT scans could predict the outcome of patients with DLBCL, treated with R-CHOP/CHOP. Three-year OS was more accurate in early and interim PET/CT using 66 %ΔSUV(max) criteria as an interpretation, while 3-year PFS was more accurate in interim PET/CT by five scores criteria.