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Objective: To investigate the role of the Deauville five-point scale (5-PS) and maximum standard uptake value variation (△ SUVmax) measures of interim positron emission tomography/computed tomography (PET-CT) in the prognosis evaluation of patients with diffuse large B-cell lymphoma (DLBCL). Methods: A total of 94 patients with histologically confirmed DLBCL at The First Affiliated Hospital of Chongqing Medical University from October 2012 to June 2018 were enrolled in this retrospective study. Clinical characteristics and prognostic factors of patients were analyzed. Survival data were analyzed using the Kaplan-Meier method and Cox proportional hazards model. The prognostic value of △SUVmax and 5-PS in patients with DLBCL was evaluated using the Chi-square test. Results: 5-PS and △SUVmax were grouped by scores of 4 and 86%, respectively. Progression free survival (PFS) and overall survival (OS) were longer in the 5-PS score <4 group than in the 5-PS score ≥4 group. Patients in the △SUVmax ≥86% group had better PFS and OS than those in the △SUVmax <86% group (P<0.05). △SUVmax and 5-PS measures had high negative predictive values (89.4% and 93.6%, respectively; 76.1% and 85.9%, respectively) and low positive predictive values (48.9% and 31.9%, respectively; 47.8% and 34.8%, respectively) for PFS and OS. △SUVmax was more sensitive than 5-PS for the corresponding parameters (82.1% vs. 39.3% and 83.3% vs. 44.4%, respectively). Univariate analysis showed that international prognostic index (IPI) (P=0.007), △SUVmax (P<0.001), 5-PS (P=0.014) and baseline total metabolic tumor volume (TMTV) (P=0.001) were associated with PFS. △SUVmax (P=0.014), 5-PS (P= 0.033), and TMTV (P=0.004) were related to OS. Multivariate analysis showed that TMTV was an independent predictor of OS (P= 0.005). △SUVmax and TMTV were independent predictors of PFS (P=0.002, P=0.020). The PFS of patients with △SUVmax < 86% and high TMTV was significantly shorter than that of those with △SUVmax <86% with low TMTV (P=0.001). Conclusions: 5-PS and △SUVmax can be used to evaluate the prognosis of DLBCL patients. However, the predictive value of △SUVmax was higher than that of 5-PS, and combining △SUVmax with baseline TMTV could further stratify the risk of DLBCL patients.
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Background@#After the first examination of patients with lymphoma diagnosis, important laboratory tests such as complete blood count; albumin, kidney and liver function tests; uric acid; β2-microglobulin; C-reactive protein (CRP); erythrocyte sedimentation rate (ESR); and lactate dehydrogenase (LDH) examinations are recommended. In this study, our aim was to find the relationship between laboratory parameters and the maximum standard uptake value (SUV) of positron emission tomography/computed tomography (PET/CT) in patients with lymphoma at the diagnosis and after treatment.@*Methods@#Thirty-four lymphoma patients treated at Mustafa Kemal University Internal Medicine Clinic between 2014 and 2017 were included in this retrospective study. Results of CRP, ESR, LDH, albumin, and white blood cell (WBC) count were recorded before each PET scan test, and each parameter was analyzed for correlation with SUVmeasurements.@*Results@#Spearman's correlation test showed that the after-treatment SUVvalues were significantly correlated with the after-treatment LDH, ESR, and CRP values (for LDH, ESR, and CRP, R: 0.453, 0.426, and 0.351; P = 0.007, 0.012, and 0.042, respectively). On the other hand, albumin and WBC count did not show a significant correlation with the after-treatment SUVvalues (all P > 0.05).@*Conclusions@#CRP, ESR, and LDH values may also be good predictors in patients for whom PET/CT imaging cannot be performed.
Subject(s)
Humans , Blood Sedimentation , C-Reactive Protein , Fluorodeoxyglucose F18 , L-Lactate Dehydrogenase , Lymphoma , Diagnostic Imaging , Multimodal Imaging , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Retrospective StudiesABSTRACT
Objective:To investigate the prognostic value of18F-FDG PET/CT by calculating maximal standard uptake values(SUVmax) in patients with pancreatic carcinoma of TOMO knife radiotherapy.Methods:Sixty five cases of pancreatic carcinoma who underwent18F-FDG PET/CT scan before TOMO radiotherapy were reviewed retrospectively, the18F-FDG uptake of primary tumors was measured with the SUVmax. SUVmax<3.0 was divided into group A(32 cases), SUVmax≥3.0 was divided into group B(33 cases), the relationship of SUVmax and other clinical factors with the survival of the 65 patients were analyzed.Results:By Log-rank univariate analysis showed that the differences in group A(SUVmax<3.0) and group B(SUVmax≥3.0) in patiengts with middle survival time was statistically significant(15.5:7 months)atP=0.001. TNM stages(x2=6.625,P<0.010), CA19-9(x2=10.298,P<0.001) and GTV dose(x2=8.054, P<0.005) were also statistically different at (P<0.05). Multivariate analysis showed that the SUVmax and preoperative serum CA19-9 level were independent risk factors that prevent the long-term survival of the prognosis of patients in this group.Conclusion: SUVmax has a certain clinical value in predicting the prognosis of patients with pancreatic cancer, and can guide clinical diagnosis and treatment planning, and extend the lifespan of patients with pancreatic carcinoma.
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ObjectiveTo explore the prognostic value of pretreated maximum standardized uptake value (SUVmax) using 18-fluorodeoxyglucose positron emission tomography with computed tomography (18FDG PET/CT) in locally-advanced nasopharyngeal carcinoma (NPC) treated by intensity-modulated radiotherapy (IMRT).MethodsOne hundred and forty previously untreated stage Ⅲ - Ⅳb ( UICC/AJCC 6th) patients with biopsy-proven nasopharyngeal carcinoma were examined.All of the enrolled patients accepted whole body/head-neck 18FDG PET/CT before radical IMRT. 18FDG uptakes were recorded as SUVmax of primary tumor (SUVmax-P) and SUVmax of cervical lymph nodes (SUVmax-N).The relationships between SUVmax and long-term clinical outcomes were analyzed.ResultsThe median SUVmax-P was 10.4,and the median SUVmax-N was 6.2.The SUVmax-P was weakly correlated with T-stage ( R =0.279,P =0.001 ).The SUVmax-N was weakly correlated with N stage ( R =0.334,P =0.000 ).There were no difference of the median SUVmax-P (9.2 vs.10.4,U =560.50,P =0.805 ) and the median SUVmax-N (4.0vs.5.0,U =576.00,P =0.908) between patients with and without local recurrence.The median SUVmax-P of patients with distant metastasis was significantly higher than those without metastasis (11.9 vs.9.8,U =987.50,P =0.014).The SUV of 10.2 was taken as a cut-off for high and low uptake tumors.For patients with SUVmax-P ＞ 10.2,the 5-year distant metastasis-free survival (DMFS) and 5-year overall survival (OS)were significantly higher than those with SUVmax-P ≤ 10.2 (69.1％ vs.95.5％,x2 =15.88,P =0.000;68.4％ vs.94.0％,x2 =15.56,P =0.000,respectively).Multivariate analysis showed that SUVmax-P was the only independent risk factor of 5-year DMFS and OS ( HR =7.87,P =0.001 and HR =5.14,P =0.003). Conclusion SUVmax-P is a useful biomarker predicting long-term clinical outcomes in newly diagnosed locally-advanced NPC patients.