Roles of PET/CT in Predicting the Prognosis of Diffuse Large B Cell Lymphoma Patients Treated with Chimeric Antigen Receptor T Cell Therapy / 中国实验血液学杂志

OBJECTIVE@#To investigate the prognosis prediction value of PET/CT in DLBCL patients treated with CAR-T therapy.@*METHODS@#The effects of PET/CT were retrospectively explored on 13 R/R DLBCL patients who were treated with CAR-T therapy. Parameters reflecting tumor metabolic burden, such as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured before and after CAR-T treatment.@*RESULTS@#Patients with larger baseline MTV or longer sum of longest diameters showed shorter overall survival (OS) time than those with low tumor burden. Patients achieved complete remission (CR), partial remission (PR) and minor remission (MR) determined by response evaluation criteria in lymphoma (RECIL) in 12 weeks showed progression-free survival and OS time superior to those of patients with no remission. In addition, it was found that 2 patients with residual masses classified as PR by contrast-enhanced CT of patients were evaluated as complete metabolic response by PET/CT imaging.@*CONCLUSION@#PET/CT shows a great value in the evaluation of prognosis and response in CAR-T-treated R/R DLBCL patients.

Prognostic Value of Baseline and Interim Total Metabolic Tumor Volume and Total Lesion Glycolysis Measured on ¹⁸F-FDG PET-CT in Patients with Follicular Lymphoma / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to investigate the prognostic significance of total metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) in patients with follicular lymphoma (FL) at baseline and mid-treatment with ¹⁸F-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) scans. MATERIALS AND METHODS: The study analyzed data from 48 patients with FL who were treated in Jiangsu Province Hospital and reviewed their baseline PET-CT scans. TMTV and TLG were computed by using the absolute value of 2.0, 2.5, and 3.0 thresholding method, respectively. RESULTS: Median age was 53 years, 75.0% of patients had stage III to IV disease, 43.8% had a Follicular Lymphoma International Prognostic Index 1 (FLIPI1) score of 3 to 5 and 20.8% had a FLIPI2 score of 3 to 5. Receiver operating characteristic (ROC) curve analysis showed the optimal cut-off values for TMTV3.0 and TLG3.0 were 476.4 (sensitivity, 85.7%; specificity, 78.0%; area under the curve [AUC], 0.760; p=0.003) and 2,676.9 (sensitivity, 71.4%; specificity, 78.0%; AUC, 0.760; p=0.003). On multivariable analysis, TMTV3.0 and TLG3.0 were independent predictors of both progression-free survival (PFS) (hazard ratio [HR], 5.406; 95% confidence interval [CI], 1.326 to 22.040; p=0.019 and HR, 6.502; 95% CI, 1.079 to 39.182; p=0.042) and overall survival (OS) (HR, 4.111; 95% CI, 1.125 to 15.027; p=0.033 and HR, 5.885; 95% CI, 1.014 to 34.148; p=0.049). ROC curve analysis showed the optimal cut-off values for ΔTMTV3.0 and ΔTLG3.0 were 66.3% (sensitivity, 85.7%; specificity, 63.4%; AUC, 0.774; p 66.3%) and TLG (ΔTLG > 64.5%) reduction are valuable tools for early treatment response assessment in FL patients.

F-FDG PET/CT Manifestation and Clinical Analysis of Primary Hepatic Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the imaging characteristics of F-FDG PET-CT and clinical presentation of patients with primary hepatic lymphoma (PHL).</p><p><b>METHODS</b>The F-FDG PET-CT image data of 6 patients with pathologically diagnosed PHL, were retrospectively analyzed.</p><p><b>RESULTS</b>The six patients included 4 male cases and 2 female cases, with median age of 65 years old , and all the cases were diagnosed as diffuse large B-cell lymphoma. In regarding of F-FDG PET-CT imaging, all the cases showed hypodense masses and high FDG uptake, with homogenous density in 5 cases and necrostic area of low density in 1 case. The SUVmax was 6.3, 9.5, 12.8, 22.1, 28.4, and 33.5, respectively. Three typical PET-CT imaging findings were as follows: 4 cases appeared as multiple nodes, 1 case was the type of solitary mass, and 1 case was the type of diffuse infiltration. 5 cases showed a mild enhancement by CT scanning, and 2 cases displayed "blood vessel floating" in. In 2 cases, MRI scanning demonstrated low signal intensity on T1WI, and homogeneous signal intensity on T2WI with mild enhancement.</p><p><b>CONCLUSION</b>The F-FDG PET-CT manifestation of PBL has a certain characteristics that can providt helpful to diagnose primary hepatic lymphoma.</p>

F-FDG PET/CT Manifestation and Clinical Analysis of Subcutaneous Panniculitis-Like T-Cell Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To explore the clinical presentation, imaging characteristics ofF-FDG PET/CT and prognosis of patients with subcutaneous panniculitis-like T-cell lymphoma (SPTCL).</p><p><b>METHODS</b>The images and clinical data of 7 patients with pathologically confirmed SPTCL who underwentF-FDG PET/CT were retrospectively analyzed.</p><p><b>RESULTS</b>Six patients displayed multiple subcutaneous nodules or deeply seated plaques, most commonly on the extremities and trunk, and one patient showed a single lesion on his face. The ulceration of nodules occurred in 3 cases, and the lesions were painful in 5 cases. Both nodal and extranodal involvements were found in 2 cases, respectively. The SUVof cutaneous lesions in extremities and trunk were 3.8(1.1-11.3) and 3.9(1.0-10.1), with out significant difference (Z=-0.248, P>0.05), but significant difference was observed between the SUVcutaneous lesions with the CT value>0HU group and that of CT value≤0HU group [7.0(3.0-11.3) vs 1.8(1.0-6.9); Z=-7.523, P<0.01]. The SUVof all cutaneous lesions, nodal and extranodal involvement were 3.9(1.0-11.3), 5.2(2.1-13.1) and 6.2(4.0-11.4), respectively, with significant difference(P<0.05). The SUVof extranodal involvement was apparently higher than that of cutaneous lesions (P<0.05). However, no significant difference of the SUVwas observed between nodal and extranodal involvement (P>0.0.5), also between nodal involvement and cutaneous lesions (P>0.05). Among 7 cases, 4 were died of multiple cutaneous lesions, and accompanied by hemophagocytic syndrome (HPS) in 3 cases, with median SUVof cutaneous lesions exceeded 3.0 in 3 cases, and nodal and extranodal involvement in 2 cases.</p><p><b>CONCLUSION</b>The clinical manifestation of SPTCL is non-specific.F-FDG PET/CT is useful for defining the distribution and extent, finding visceral involvement, judging the malignant degree, predicting the prognosis, and making effective therapeutic plan.</p>

Clinical Value ofF-FDG PET/CT for Patients with B Cell Lymphoma-Associated Hemophagocytic Syndrome / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the clinical value ofF-FDG PET/CT for patients with B cell lymphoma-associated hemophagocytic syndrome.</p><p><b>METHODS</b>The clinical characteristics, laboratory parameters andF-FDG PET/CT data of 23 newly diagnosed patients sufferred from B cell lymphoma-associated hemophagocytic syndrome were retrospectively analyzed. The correlation between PET and laboratory parameters were determined using Spearman correlation test. The prognostic factors were analyzed by the Kaplan-Meier method.</p><p><b>RESULTS</b>23 patients were all examined byF-FDG PET/CT before chemotherapy, theF-FDG uptake of spleen positively correlated with neutrophil count and hemoglobin content (r=0.588, P=0.035;r=0.699, P=0.008), respectively, and theF-FDG uptake of bone marrow positively correlated with neutrophil count only (r=0.691, P=0.009). Among all the clinical or laboratorial parameters andF-FDG PET/CT, only PET parameter was poor factor affecting prognosis of patients with B cell lymphoma-associated hemophagocytic syndrome. Out of 6 patients received PET/CT scans after 6 cycles of treatment, the 5 patients with negative PET/CT survived, and one patient with positive result died.</p><p><b>CONCLUSION</b>BaselineF-FDG PET/CT may provide prognostic information for the management of patients with B cell lymphoma-associated hemophagocytic syndrome, and the data ofF-FDG PET/CT before chemotherapy may predict the pregnosis of the patients with negative results, and the negative PET/CT results after chemotherapy betokens a better prognosis of patients.</p>

Value of PretherapeuticF-FDG PET/CT in the Diagnosis, Staging and Prognosis Evaluation of Adult Burkitt's Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the value of pretherapeuticF-FDG PET/CT in the focus detection, staging and prognosis evaluation of adult Burkitt's lymphoma(BL).</p><p><b>METHODS</b>The clinical data and detection results ofF-FDG PET/CT scan of 18 patients with BL before the treatment from December 2008 to February 2015 were analyzed retrospectively. The lesions distribution were observed, the maximal standard uptake value(SUV) ofF-FDG by lesions and the maximal diameter of lymph nodes were measured. One-way analysis of variance was used to analyze the SUV, and the Spearman correlation was used to analyze the relationship between SUVand the maximum diameter of lymph nodes. The prognostic factors were analyzed by using Kaplan-Meier survival analysis.</p><p><b>RESULTS</b> F-FDG PET/CT showed 100% positive detection rate for 18 adults with BL, lymph nodal lesions were found in all the patients, and the most common area was lymphonodi coeliaci (9/18, 50%), 8 cases showed extranodal soft tissue involvement, 6 cases showed gastrointestinal tract, bone marrow involvement was detected in 7 cases, out of which the mutiple-focal involvement was found in 4 cases. The median SUVof lymph nodes, extranodal soft tissue and bone marrow was 11.7 (range of 3.4 to 28.5), 9.85 (range of 6.7 to 21.9) and 11.8(range of 5.6 to 23.8), respectively, there were no significant differences among these 3 types of lesions (F=1.013, P=0.369). And the median SUVof all lesions was 16.5 (range of 8.8 to 28.5). The clinical staging of 2 patients (2/8, 11.1%) was changed byF-FDG PET/CT imaging. The univariate analysis revealed that only the IPI (international prognostic index) could be the prognostic factor (χ=6.602, P=0.010), but the prognosis was not different between the patients below and above the median SUVof all lesions and lymph node (all P>0.05).</p><p><b>CONCLUSION</b>BL in adult is an intenselyF-FDG-avid tumor, theF-FDG PET/CT is an effective imaging tool for the detection and staging of this disease. In our study, the prognostic value of pretherapeuticF-FDG PET/CT still is unclear, that is not recommended for the prognosis of the adult BL patients.</p>

PET-CT Manifestation and Clinical Analysis of Waldenstrom Macroglobulinemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the PET-CT manifestation and clinical features of patients with Waldenstrom macroglobulinemia(WM) .</p><p><b>METHODS</b>The clinical features, laboratorial examination results and PET-CT manifestation of 12 patients with WM were analyzed retrospectively.</p><p><b>RESULTS</b>The average age of 12 patients with WM was 63.5 years old, the most common incipient symptoms were fatigue and hyperviscosity syndrome. The median SUVof bone marrow was 4.9 (range of 2.1 to 21.9), with diffusely increasedF-FDG uptake in all the patients. In 6 patients, the median SUVof splenomegaly and lymphadenectasis was 3.2 (range of 2.3 to 5.2) and 5.2 (range of 3.6 to 11.2), respectively. The SUVof bone marrow, splenomegaly and lymphadenectasis did not related with white blood cell count, hemoglobin level, blood platelet count, β2- microglobulin level and serum monoclonal IgM of such patients, respectively (both P>0.5). In univariate analysis, serum monoclonal IgM and the SUVof lymphadenectasis were found to be the prognostic factors (both P<0.5).</p><p><b>CONCLUSION</b>TheF-FDG PET-CT feature of Waldenstrom macroglobulinemia has some characteristics which are helpful for setting up the clinical therapeutic schedule.</p>

Value of PET/CT after Chemotherapy for Evaluating Therapentic Efficacy of Patients with Diffuse Large B-cell Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the value of PET/CT after chemotherapy for evaluating therapeutic efficacy of patients with diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>(18)F-FDG PET/CT was performed before and after 6-8 cycles of chemotherapy in 73 newly diagnosed patients with DLBCL from September 2005 to January 2012. The results of pre-treatment PET/CT was compared with results of post-treatment PET/CT. These patients were divided into 3 groups: complete response group, partial response group and no response group. The post-treatment PET/CT results was used to assess its ability to predict progression-free survival (PFS) and overall survival (OS).</p><p><b>RESULTS</b>The comparison of PET/CT results before and after chemotherapy showed that 2-year PFS rates of complete response group, partial response group and no response group were 82% (41/50), 45.5% (5/11) and 8.3% (1/12), respectively; and the 3-year OS rates of 3 groups were 88% (44/50), 54.5% (6/11) and 8.3% (1/12) respectively (both P < 0.01). The 2-year PFS rate and the 3-year OS rate of the complete response group and partial response group were significantly higher than those of no response group (both P < 0.05), and there was also significant statistical difference between partial response group and complete response group in 2-year PFS rate and 3-year OS rate (both P < 0.05).</p><p><b>CONCLUSION</b>The post-treatment PET/CT can be accurately used to evaluate the curative efficacy of chemotherapy and prognosis of patients with DLBCL.</p>

Prognostic Value of Maximum Standard Uptake on Pretreatment ¹⁸F-FDG PET/CT Scan in Newly Diagnosed Follicular Lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To determine the prognostic value of maximum standard uptake (SUV(max)) of pretreatment ¹⁸F-FDG PET/CT scan in newly diagnosed follicular lymphoma (FL).</p><p><b>METHODS</b>The clinical data and detection results of ¹⁸F-FDG PET/CT scan of 30 patients with FL before treatment from November 2005 to October 2013 were analyzed retrospectively. The relation of SUV(max) with prognostic factors, therapeutic efficacy and survival time was evaluated in term of pathologic grade, FLIPI2 absence and presence of bulky disease and bone marrow involvement, clinical indicators and outcome of treatment.</p><p><b>RESULTS</b>There was significant differences of SUV(max) among pathological grade 1, grade 2 and grade 3 (P = 0.040), but no significant difference was found among FLIPI 2 low risk group, intermediate risk group and high risk groups (P = 0.431). No difference of SUV(max) was observed in patients with and without bulky disease, or with and without bone marrow involvement (both P > 0.05). SUV(max) was not related with such patient characteristics as stage, β2-microglobulin level, hemoglobin content, lactate dehydrogenase and Ki-67 (both P > 0.05). And the difference of SUV(max) was no significant for patients with complete remission (CR) and non-CR, or with efficacy and no efficacy (both P > 0.05). With the cutoff values of 10 and 15, the CR rate, overall response rate, 3-year progression-free survival (PFS) rate and 2-year overall survival (OS) rate were not different between the patients with SUV(max) below and above cut-off value (both P > 0.05).</p><p><b>CONCLUSION</b>In our study the prognostic value of SUV(max) on PET/CT is indeterminate, and it can not be used to predict the FL patients prognosis.</p>

Application of 18F-FDG PET/CT images in the newly diagnosed extranodal NK/T cell lymphoma / 中国实验血液学杂志

<p><b>OBJECTIVE</b>This study was to explore the use value of (18)F-FDG PET/CT in patients with extranodal NK/T cell lymphoma (ENKTL).</p><p><b>METHODS</b>Both PET/CT and CT images were retrospectively analyzed in 43 newly diagnosed patients with ENKTL, and the anatomical position, extent of foci, subtypes, staging and therapeutic regimen determined by both these 2 imaging methods were compared, and relationship between the maximum standard uptake value (SUV(max)) and subtypes, different staging and constitutional symptoms were evaluated.</p><p><b>RESULTS</b>The top four anatomical positions involved were nose (76.74%), pharynx nasalis (41.86%), Waldeyer's ring (30.23%) and paranasal sinus (27.91%), respectively according to the results of the PET/CT examination, and (18)F-FDG uptake was not found in four patients in the region of upper aerodigestive tract. The PET/CT staging was significantly correlated with constitutional symptoms (P < 0.01). The mean SUV(max) of 43 patients was 13.65 ± 6.35, and the SUV(max) of advanced stages (III/IV) was higher than that of early stage (I/II). Different staging results were found in 21 patients between PET/CT and CT images, 14 patients out of them had direct influence on the treatment plan. Staging of 8 cases was changed from early stage judged by CT image into advaneed stage judged by PET/CT, and radiotherapy regimen of 6 cases at early stage were altered because of the application of PET/CT.</p><p><b>CONCLUSION</b>The location and scope of foci in ENKTL patients can be displayed more accurately by PET/CT, the PET/CT is more accurate and reliable than traditional CT image, and has considerable value in determining the treatment plan, and it should be applied in clinical practice widely.</p>