| Part ?Evaluation of the efficacy of PET-VCAR metabolic parameters in the clinicopathological diagnosis of lymphomaObjective:To evaluate and compare the efficacy of PET metabolic parameters MTV,TLG,SULpeak,SUVmax and SUVmean in the clinicopathological diagnosis of lymphoma,and to retrospectively explore the clinical diagnostic evaluation value of the above indicators in lymphoma.Methods:MTV,TLG,SULpeak,SUVmax and SUVmean were measured in 150 patients by PET-VCAR with lymphoma confirmed by hiopathology and none of the patients were treated before.Using the threshold value of 41%of SUVmax,the metabolic parameters of the highest metabolic lesion were automatically calculated.All patients with lymphoma were divided into two groups according to the age,gender,Ann Arbor stage,pathological type and invasion.The Mann-Whitney U test was used to compare the differences among the groups,and the ROC curve and AUC were drawn to evaluate the efficacy of each metabolic parameter in the clinicopathological diagnosis of lymphoma.Results:The comparison between the Ann Arbor stage groups showed that MTV and TLG of the ??? group were significantly lower than those of the ???group(all P<0.05),while SULpeak,SUVmax and SUVmean had no significant difference between the two groups(all P>0.05).The five metabolic indexes of invasive NHL were all higher than those of indolent NHL(all P<0.05),while there were no significant differences in the five indexes among age groups,gender groups,HL and NHL groups(all P>0.05).To differentiate lymphoma in Ann Arbor stage ???and ???,the sensitivities of MTV and TLG were 46.91%and 43.21%respectively,and the specificities were 88.41%and 82.61%,respectively.The cut-off values were 32.87 and 343.54,with the AUCs being 0.674 and 0.647 respectively.The sensitivities of MTV,TLG,SULpeax,SUVmax and SUVmean to distinguish between invasive and indolent NHL were 91.78%,82.19%,71.23%,71.23%and 52.05%,respectively,and the specificities were 82.35%,82.35%,85.29%,82.35%and 91.18%,respectively.The cut-off values were 15.95,118.83,9.93,13.12 and 10.21,with the AUCs being 0.923,0.900,0.846,0.801 and 0.737,respectively.The AUCs of MTV,TLG and SULpeak were all higher than those of SUVmax and SUVmean(all P<0.05).The AUC of SUV nax was higher than that of SUVmean(P<0.05).Conclusion:MTV and TLG had certain diagnostic efficacy in Ann Arbor staging of lymphoma.The five indexes have certain diagnostic efficacy for the differentiation between invasive and indolent NHL,among which MTV,TLG and SULpeak are superior to the traditional index SUV in the differentiation between invasive and indolent NHL,and the MTV has the best performance.Part ?Clinical value of metabolic assessment of PET-VCAR in the follow-up of lymphomaObjective:To compare the efficacy of RECIST 1.1,which is traditionally evaluated based on anatomical size change,and PERCIST 1.0,which takes SULpeak as a quantitative indicator of treatment response,in the follow-up of treatment efficacy of lymphoma,and discuss the clinical value of PERCIST1.0 in the follow-up of treatment efficacy of lymphoma.Methods:Efficacy was evaluated in 93 histopathologically confirmed lymphoma patients using PET-VCAR,all including 68 non-Hodgkin's lymphoma and 25 Hodgkin's lymphoma.All patients received PET/CT baseline scan before treatment,and the efficacy was observed by PET/CT examination 4 weeks after chemotherapy.The results were quantitatively analyzed by RECIST1.1 and PERCIST 1.0.Kappa test was used to compare the consistency of RECIST1.1 and PERCIST1.0 criteria in the treatment of lymphoma,and paired ?2 test was used to compare the response rate(RR).The differences of progression free survival(PFS)among different groups were analyzed using the Kaplan-Meier survival curve.After log-rank test,P<0.05 was considered statistically significant.Results:Among the 93 cases with lymphoma,68 cases with non-Hodgkin's lymphoma and 25 cases with Hodgkin's lymphoma,all the consistency test results show poor consistency(?=0.272,0.253,0.316).Paired ?2 test showed that among the 93 cases with lymphoma,the RR of RECIST 1.1 was 45.16%(42/93),and the RR of PERCIST 1.0 was 63.44%(59/93).The difference was statistically significant(P=0.003).Among the 68 cases with non-Hodgkin's lymphoma,the RR of RECIST 1.1 was 50.00%(34/68),and the RR of PERCIST 1.0 was 66.18%(45/68).The difference was statistically significant(P=0.043).Among the 25 cases with Hodgkin's lymphoma,the RR of RECIST 1.1 was 32.00%(8/25),and the RR of PERCIST 1.0 was 56.00%(14/25).The difference was statistically significant(P=0.031).When RECIST 1.1 criteria was used for comparison,the effective group(CR+PR)of 93 cases of lymphoma,68 cases of non-Hodgkin's lymphoma and 25 cases of Hodgkin's lymphoma showed no significant advantage compared with the non-effective group(SD+PD),and the difference was not statistically significant(all P>0.05).When PERCIST 1.0 criteria was used for comparison,the effective group(CMR+MPR)of 93 cases of lymphoma,68 cases of non-Hodgkin's lymphoma and 25 cases of Hodgkin's lymphoma showed significant advantage compared with the non-effective group(SMD+PMD)(all P<0.05).Conclusion:Compared with the traditional RECIST 1.1 standard based on anatomical size change to evaluate efficacy,PERCIST1.0 standard with SULpeak as the quantitative indicator of treatment response can provide accurate and reliable efficacy information after lymphoma treatment and objectively and reasonably predict the prognosis of patients. |
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