Prognostic evaluation value of 18F-FDG PET-CT in Hodgkin′s lymphoma after treatment
10.3760/cma.j.cn112152-20191212-00799
- VernacularTitle:18F-氟代脱氧葡萄糖正电子发射计算机断层扫描在治疗后霍奇金淋巴瘤预后预测中的作用
- Author:
Huan WAN
1
;
Peng LIU
;
Ying LIANG
;
Shiyu JIANG
;
Lyu LYU
;
Zewei ZHANG
;
Ning WU
;
Ying LIU
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院PET-CT中心 100021
- Keywords:
Hodgkin lymphoma;
Prognosis;
PET-CT;
Deauville 5-point scale;
Standardized uptake value
- From:
Chinese Journal of Oncology
2021;43(12):1275-1281
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the prognostic value of 18F-fluorodeoxygen-D-glucose-positron emission tomography /computerized tomography ( 18F-FDG-PET-CT) in Hodgkin′s lymphoma (HL) at the end of first-line treatment (PET-end), by comparing the ratio of maximum standardized uptake value (SUV max) of lesion and liver SUV (rLL), SUV max reduction between baseline PET (PET-0) and PET-end (ΔSUV max), and Deauville 5-point scale (5-PS). Methods:Patients with HL newly treated in our hospital from August 2006 to December 2015 were retrospectively analyzed. All the patients enrolled in the study underwent post-treatment FDG PET-CT. The rLL and ΔSUV max were calculated, and all the cases were scored using Deauville 5-PS. The receiver operating characteristic (ROC) approach was applied to identify the optimal cut-point value, and survival curves according to different PET-CT assessment methods were estimated using the Kaplan-Meier analysis. The prognostic efficacy of different PET-CT assessment methods was compared, and DeLong test was used to verify it. Kaplan-Meier method and multivariate analysis using the Cox proportional hazards model were performed to analyze the potential independent risk factors. Results:There were 5 patients progressed within a 3-year follow-up. In the three PET-CT assessment methods, the predictive value of rLL and Deauville 5-PS were significant effective. ROC analysis for rLL as a progression predictor showed an optimal cut-point of 1.29. Deauville 5-PS=4 and rLL=1.29 showed the best prognostic accuracy. The sensitivity of rLL and Deauville 5-PS were both 80.0%, and the specificity of each was 98.0% and 93.7%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of rLL were 66.7% and 98.7%, while the PPV and NPV of 5-PS were 44.4% and 98.7%. The 3-years progression-free survival (PFS) rates of rLL≥1.29 group and rLL<1.29 group were 33.3% and 98.7%, with significant difference ( P<0.001). The 3-years PFS rates of post-treatment Deauville 5-PS<4 group and Deauville 5-PS≥4 group were 98.7% and 55.6%, with significant difference ( P<0.001). The prognostic evaluation efficacy of rLL was positively correlated with that of Deauville 5-PS ( r=0.75, P<0.05). Area under curves (AUC) of rLL and Deauville 5-PS were 0.93 (95% CI: 0.825-1.000) and 0.91 (95% CI: 0.757-1.000), respectively. DeLong test showed the significant difference between the two methods ( P<0.05). The univariate analysis results showed that clinical baseline stage, post-treatment rLL and Deauville 5-PS were associated with the prognoses of HL patients ( P<0.05). The multivariate analysis results showed that post-treatment rLL and Deauville 5-PS were independent prognostic factors of HL ( P<0.05). Conclusions:The rLL and Deauville 5-PS are potential prognostic factors for HL response assessment. The new semi-quantitative method rLL has methodological advantages over visual analysis, and it is a good supplement for Deauville 5-PS. rLL can improve prognostic evaluation accuracy of PET-CT and is useful to early identify patients with HL at a high risk of relapsing after first-line treatment.
