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Abstract：
OBJECTIVE: 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is the standard imaging modality for response evaluation in FDG-avid lymphoma, but the prognostic value is not established in follicular lymphoma (FL). This study investigated the prognostic value of Deauville 5-point scale (D5PS) from paired interim PET/CT (PETInterim) and end-of-induction therapy PET/CT (PETEOI) in patients with FL.
METHODS: FL staging and response assessment PET/CT images from 2013 to 2015 were retrospectively reviewed. PETInterim was performed 3 or 4 cycles after chemotherapy and PETEOI after 6 or 8 cycles. D5PS scores of 1, 2, and 3 were considered as negative (-), and scores 4 and 5 were considered as positive (+). Statistical analysis was done using Cox regression analysis, Kaplan-Meier survival analysis, and the log-rank test.
RESULTS: Thirty-three patients with set of baseline, interim, and end-of-induction therapy PET/CT studies were included. Ten patients (30.3%) had progression. The median progression-free survival (PFS) was 38.8 months (range 3.5-72.7 months). On PETInterim, 23 patients were negative and 10 were positive. On PETEOI scans, 29 patients were negative, and 4 were positive. On multivariate analysis, PETEOI(-) was associated with longer PFS. PETInterim(+) and PETEOI(+) patients had a significantly shorter PFS than PETInterim(-) patients (39.9 months, 95% confidence interval [CI] 23.0-56.9, versus 55.5 months, 95% CI 49.7-61.2, p = 0.005) and PETEOI(-) patients (14.2 months, 95% CI 8.5-19.8, versus 60.5 months, 95% CI 52.1-69.0, p < 0.001).
CONCLUSIONS: For patients with FL, PETInterim and PETEOI response is predictive of PFS, and PETEOI(+) is an independent prognostic factor for progression of FL.
METHODS: FL staging and response assessment PET/CT images from 2013 to 2015 were retrospectively reviewed. PETInterim was performed 3 or 4 cycles after chemotherapy and PETEOI after 6 or 8 cycles. D5PS scores of 1, 2, and 3 were considered as negative (-), and scores 4 and 5 were considered as positive (+). Statistical analysis was done using Cox regression analysis, Kaplan-Meier survival analysis, and the log-rank test.
RESULTS: Thirty-three patients with set of baseline, interim, and end-of-induction therapy PET/CT studies were included. Ten patients (30.3%) had progression. The median progression-free survival (PFS) was 38.8 months (range 3.5-72.7 months). On PETInterim, 23 patients were negative and 10 were positive. On PETEOI scans, 29 patients were negative, and 4 were positive. On multivariate analysis, PETEOI(-) was associated with longer PFS. PETInterim(+) and PETEOI(+) patients had a significantly shorter PFS than PETInterim(-) patients (39.9 months, 95% confidence interval [CI] 23.0-56.9, versus 55.5 months, 95% CI 49.7-61.2, p = 0.005) and PETEOI(-) patients (14.2 months, 95% CI 8.5-19.8, versus 60.5 months, 95% CI 52.1-69.0, p < 0.001).
CONCLUSIONS: For patients with FL, PETInterim and PETEOI response is predictive of PFS, and PETEOI(+) is an independent prognostic factor for progression of FL.
摘要：
■18F-氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）是FDG狂热淋巴瘤反应评估的标准成像模式，但滤泡性淋巴瘤（FL）的预后价值尚未确定。这项研究调查了来自配对的临时PET/CT（PETInterim）和诱导治疗结束PET/CT（PETEOI）的Deauville5点量表（D5PS）在FL患者中的预后价值。对2013年至2015年的
■FL分期和反应评估PET/CT图像进行回顾性回顾。PETInterim在化疗后3或4个周期进行，PETEOI在6或8个周期后进行。1、2和3的D5PS评分被认为是负的（-），评分4和5被认为是阳性(+)。统计学分析采用Cox回归分析,Kaplan-Meier生存分析，和对数秩检验。
■33名患者的基线，临时，并纳入了诱导治疗结束的PET/CT研究。10例患者（30.3%）进展。中位无进展生存期（PFS）为38.8个月（范围3.5-72.7个月）。在PET临时，23例阴性，10例阳性。在PETEOI扫描中，29例患者阴性，4是积极的。在多变量分析中，PETEOI(-)与较长的PFS相关。PETInterim(+)和PETEOI(+)患者的PFS明显短于PETInterim(-)患者(39.9个月,95%置信区间[CI]23.0-56.9，与55.5个月相比，95%CI49.7-61.2，p=0.005）和PETEOI（-）患者（14.2个月，95%CI8.5-19.8，与60.5个月相比，95%CI52.1-69.0，p<0.001）。
■对于FL患者，PETInterim和PETEOI反应可预测PFS，PETEOI(+)是FL进展的独立预后因素。
■FL分期和反应评估PET/CT图像进行回顾性回顾。PETInterim在化疗后3或4个周期进行，PETEOI在6或8个周期后进行。1、2和3的D5PS评分被认为是负的（-），评分4和5被认为是阳性(+)。统计学分析采用Cox回归分析,Kaplan-Meier生存分析，和对数秩检验。
■33名患者的基线，临时，并纳入了诱导治疗结束的PET/CT研究。10例患者（30.3%）进展。中位无进展生存期（PFS）为38.8个月（范围3.5-72.7个月）。在PET临时，23例阴性，10例阳性。在PETEOI扫描中，29例患者阴性，4是积极的。在多变量分析中，PETEOI(-)与较长的PFS相关。PETInterim(+)和PETEOI(+)患者的PFS明显短于PETInterim(-)患者(39.9个月,95%置信区间[CI]23.0-56.9，与55.5个月相比，95%CI49.7-61.2，p=0.005）和PETEOI（-）患者（14.2个月，95%CI8.5-19.8，与60.5个月相比，95%CI52.1-69.0，p<0.001）。
■对于FL患者，PETInterim和PETEOI反应可预测PFS，PETEOI(+)是FL进展的独立预后因素。
