18F-脱氧葡萄糖PET传统参数及影像组学特征对弥漫性大B细胞淋巴瘤预后的预测价值

Prognostic value of 18F-FDG PET traditional parameters and radiomics characteristics for diffuse large B-cell lymphoma

目的:探讨18F-脱氧葡萄糖(FDG)PET传统参数及影像组学特征在弥漫性大B细胞淋巴瘤(DLBCL)接受一线免疫化疗治疗中的预后预测价值以及对国际预后指数(IPI)预测DLBCL患者预后的潜在附加价值。方法:回顾性分析绍兴文理学院附属第一医院2016年11月—2020年9月诊断的41例DLBCL患者资料,记录患者的PET传统参数以及相应的临床特征。使用最大代谢肿瘤体积(MBV)提取18F-FDG PET影像组学参数,以2年无进展生存期(PFS)为随访指标,将提取的特征进行筛选。采用Kaplan-Meier生存分析和单因素、多因素比例风险回归模型(Cox模型)进行PFS分析,使用受试者操作特征(ROC)曲线评估模型性能。结果:单因素Cox模型发现影像组学特征Correlation_AllDirection_offset4、Correlation_angle135_offset1、Maximum3DDiameter以及PET传统参数总代谢肿瘤体积(TMTV)、总病变糖酵解(TLG)是PFS的预测因子;Kaplan-Meie生存分析显示,高危组患者PFS发生率均高于低危组;多因素Cox生存分析显示TLG是PFS的独立预测因子。此外,影像组学特征以及传统参数均对IPI预测DLBCL患者一线治疗后结局存在潜在附加价值。结论:18F-FDG PET传统参数及影像组学特征在预测DLBCL接受一线免疫化疗治疗的预后具有积极价值,并且对IPI预测DLBCL患者预后存在潜在附加价值。

Objective To investigate the traditional parameters of 18F-FDG PET images and radiomic features in diffuse large B-cell prognostic value of diffuse large B cell lymphoma(DLBCL)in first-line immunotherapy and the potential added value of the international prognostic index(IPI)for prognostic outcomes in DLBCL patients.Methods The retrospective study included 41 DLBCL patients diagnosed in the First Affiliated Hospital of Shaoxing University from November 2016 to September 2020.PET traditional parameters of each patient and corresponding clinical features were recorded.Using metabolic bulk volume extracted the 18F-FDG PET radiomic parameters,and used 2-year progression-free survival(PFS)as the follow-up index.The extracted features were screened.Kaplan-Meier survival analysis and univariate and multifactor Cox proportional risk regression model(Cox model)were used to analyze PFS,the model was evaluated using the receiver operating characteristic(ROC)curve.Results Univariate Cox regression revealed that radiomic characteristics Correlation_AllDirection_offset4,Correlation_angle135_offset1 and Maximum3DDiameter features and PET traditional parameters total metabolic tumor volume(TMTV)and total lesion glycolysis(TLG)were predictors of PFS,Kaplan-Meie survival analysis showed that the incidence of PFS in high-risk group was significantly higher than that in low-risk group,and multivariate Cox survival analysis showed that TLG was independent predictor of PFS.In addition,radiomic features,as well as traditional characteristics,have potential added value to IPI in predicting outcomes after firstline therapy in DLBCL patients.Conclusions The traditional and radiomic parameters of 18F-FDG PET have a positive value in predicting the prognosis of DLBCL treated with first-line immunochemotherapy,and have potential added value for IPI in predicting the prognosis of DLBCL patients.