Usefulness of carbon-11-labeled methionine positron-emission tomography for assessing the treatment response of primary central nervous system lymphoma
Usefulness of carbon-11-labeled methionine positron-emission tomography for assessing the treatment response of primary central nervous system lymphoma
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碳 11 标记蛋氨酸正电子发射断层扫描在评估原发性中枢神经系统淋巴瘤治疗反应中的用途
DOI：
10.1093/jjco/hyaa010
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发表时间：
2020
影响因子：
2.4
通讯作者：
Narita Yoshitaka
中科院分区：
文献类型：
--
作者：
Miyakita Yasuji;Ohno Makoto;Takahashi Masamichi;Kurihara Hiroaki;Katai Hitoshi;Narita Yoshitaka
背景：原发性中枢神经系统淋巴瘤（PCNSL）对化疗或放疗反应相对较快。然而，治疗后的完全反应（CR）的确定往往是困难的，因为极轻的残留对比度增强的磁共振图像由于显微镜和疤痕组织形成的影响。这些小的增强病灶定义为未证实的完全缓解（CRu）。本研究的目的是探讨碳-11-标记的蛋氨酸（11 C-Met）正电子发射断层扫描（PET）用于确定PCNSL的治疗反应的有用性。方法：回顾了2011年至2015年期间接受PCNSL治疗并接受MRI和11 C-Met PET检查的36例患者的数据。MRI结果分类为CR、CRu和肿瘤肿块（TM;部分缓解、疾病稳定和疾病进展的复合终点）。评估PET图像，量化标准化摄取值，并计算肿瘤与正常组织计数比（TNR）。结果：区分CR和CRu与TM的最佳TNR分别为1.83（曲线下面积[AUC]，0.951）和1.80（AUC，0.932）。结论：TNR ≥ 1.80有助于11 C-Met PET诊断活动性PCNSL，TNR ≥ 1.80有助于11 C-Met PET诊断活动性PCNSL，TNR ≥ 1.80有助于11 C-Met PET诊断活动性PCNSL。因此，11 C-Met-PET可能是一个有用的工具，准确评估治疗效果的PCNSL。
Background: Primary central nervous system lymphoma (PCNSL) responds relatively quickly to chemotherapy or radiotherapy. However, determination of a complete response (CR) after treatment is often difficult because of extremely light residual contrast enhancement on magnetic resonance images due to the effects of microhemorrhages and scar tissue formation. These small enhancing lesions define an unconfirmed complete response (CRu). The aim of this study was to investigate the usefulness of carbon-11-labeled methionine (11C-Met) positron-emission tomography (PET) for determining the treatment response of PCNSL.Methods: Data for 36 patients who were treated for PCNSL between 2011 and 2015 and underwent MRI and 11C-Met PET were reviewed. MRI findings were classified as CR, CRu, and tumor mass (TM; a composite of partial response, stable disease, and progressive disease). PET images were evaluated, standardized uptake values were quantified, and the tumor to normal tissue count ratio (TNR) was calculated. Receiver operating characteristic curves were generated to determine the optimal cut-off TNRs.Results: The optimal TNRs for differentiating CR and CRu from TM were 1.83 (area under the curve [AUC], 0.951) and 1.80 (AUC, 0.932), respectively. The corresponding sensitivity and specificity values for the diagnosis of TM were 82.4% and 100%, respectively, in the CR group and 85.3% and 85%, respectively, in the CRu group.Conclusions: A TNR of≥ 1.80 can aid in the detection of active PCNSL using 11C-Met PET. Thus, 11C-Met-PET may be a useful tool for accurate evaluation of the treatment efficacy in PCNSL.