2-[18F]-FDG PET/CT Role in Detecting Richter Transformation of Chronic Lymphocytic Leukemia and Predicting Overall Survival
2-[18F]-FDG PET/CT Role in Detecting Richter Transformation of Chronic Lymphocytic Leukemia and Predicting Overall Survival
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DOI：
10.1016/j.clml.2020.12.003
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发表时间：
2021-02-20
影响因子：
2.7
通讯作者：
Bertagna, Francesco
中科院分区：
文献类型：
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作者：
Albano, Domenico;Camoni, Luca;Bertagna, Francesco
本研究探讨了2-脱氧-2-[18 F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）及其代谢特征对里希特综合征（RS）检测的潜在价值及其对总生存期的影响。RS组的所有PET/CT代谢参数均显著高于非RS组，代谢肿瘤体积和总病变糖酵解除外。RS患者的总生存期显著短于无RS患者。半定量PET/CT参数是独立的预后factor.Introduction：慢性淋巴细胞白血病（CLL）是一种惰性，低级别的B细胞淋巴增生性疾病，这可能会演变成侵袭性淋巴瘤，一种现象称为里希特综合征（RS）。我们的目的是研究2-脱氧-2-[18 F]氟-D-葡萄糖正电子发射断层扫描/计算机断层扫描（2-[18 F]-FDG PET/CT）的准确性及其半定量参数检测RS和对总生存期（OS）的影响。材料与方法：回顾性分析80例经病理证实的慢性淋巴细胞白血病患者。通过估计最大标准化摄取值体重（SUVbw）、瘦体重（SUVIbm）、体表面积（SUVbsa）、病变与血池SUV比（L-BP SUV R）、病变与肝脏SUV比（L-L SUV R）、总病变糖酵解（TLG）和代谢性肿瘤体积（MN）对PET/CT图像进行定性和半定量检查，并将其与主要临床组织学变量进行比较。根据Kaplan-Meier方法绘制OS曲线。结果：78例患者2-[F-18]-FDG PET/CT阳性，而其余2例患者为非FDG-avid。RS组的所有PET/CT代谢参数均显著高于非RS组，MTV和TLG除外。确定的最佳阈值为：SUVbw为9，SUVibm为5.3，SUVbsa为1.7，L-L SUV R为2，L-BP SUV R为4.8。中位随访32个月后，24例患者死亡; RS患者的OS显著短于无RS患者（16.5 vs. 27.8个月; P = 0.001）。Binet分期、B症状、SUVbw、SUVIbm、SUVbsa、L-L SUV R和L-BP SUV R被证明是独立的预后特征。结论：与SUV相关的半定量PET/CT参数可能有助于区分患有RS的高风险患者，也可用于预测OS。（C）2020 Elsevier Inc. All rights reserved.
The present study investigated the potential value of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (PET/CT) and its metabolic features for the detection of Richter syndrome (RS) and the impact on overall survival. All PET/CT metabolic parameters were significantly higher in RS compared with the no-RS group, except for metabolic tumor volume and total lesion glycolysis. Overall survival was significantly shorter in patients with RS than in patients without RS. Semiquantitative PET/CT parameters were independent prognostic factors.Introduction: Chronic lymphocytic leukemia (CLL) is an indolent, low-grade B-cell lymphoproliferative disorder, which may evolve into aggressive lymphoma, a phenomenon called Richter syndrome (RS). Our aim was to study the accuracy of 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (2-[18F]-FDG PET/CT) and its semiquantitative parameters for the detection of RS and the impact on overall survival (OS). Materials and Methods: Eighty patients with histologically proven CLL were retrospectively included. PET/CT images were qualitatively and semiquantitatively examined by estimating the maximum standardized uptake value body weight (SUVbw), lean body mass (SUVIbm), body surface area (SUVbsa), lesion-to-blood-pool SUV ratio (L-BP SUV R), lesion-to-liver SUV ratio (L-L SUV R), total lesion glycolysis (TLG), and metabolic tumor volume (MN) and comparing them with the main clinical-histologic variables. OS curves were plotted according to the Kaplan-Meier method. Results: Seventy-eight patients had positive 2-[F-18]-FDG PET/CT, whereas the remaining 2 were not FDG-avid. All PET/CT metabolic parameters were significantly higher in the RS group compared with the no-RS group, except for MTV and TLG. The best thresholds identified were 9 for SUVbw, 5.3 for SUVIbm, 1.7 for SUVbsa, 2 for L-L SUV R, and 4.8 for L-BP SUV R. After a median follow-up of 32 months, 24 patients died; OS was significantly shorter in patients with RS than patients without RS (16.5 vs. 27.8 months; P = .001). Binet-stage, B symptoms, SUVbw, SUVIbm, SUVbsa, L-L SUV R, and L-BP SUV R were shown to be independent prognostic features. Conclusions: Semi-quantitative PET/CT parameters that are SUV-related may be useful in discriminating patients with a high risk of developing RS and also for predicting OS. (C) 2020 Elsevier Inc. All rights reserved.