基线PET放射组学在弥漫性大B细胞淋巴瘤预测结果方面优于IPI风险评分。
Baseline PET radiomics outperform the IPI risk score for prediction of outcome in diffuse large B-cell lymphoma.
发表日期：2023 Mar 31
作者：
Jakoba Johanna Eertink, Gerben Jc Zwezerijnen, Martijn Heymans, Simone Pieplenbosch, Sanne Elisabeth Wiegers, Ulrich Dührsen, Andreas Hüttmann, Lars Kurch, Christine Hanoun, Pieternella J Lugtenburg, Sally Barrington, N George Mikhaeel, Luca Ceriani, Emanuele Zucca, Sandor Czibor, Tamás Györke, Martine E D Chamuleau, Otto S Hoekstra, Henrica Cw De Vet, Ronald Boellaard, Josée M Zijlstra
来源：
BLOOD
摘要：
本研究旨在对HOVON-84试验中开发的临床PET模型进行外部验证，并比较我们的临床PET模型与国际预后指数（IPI）的模型表现。共纳入1195例弥漫性大B细胞淋巴瘤患者，其中887例来自6项外部验证数据集。主要结局为2年无进展生存（PFS）和2年进展时间（TTP）。提取代谢性肿瘤体积（MTV）、最大病变和另一病变之间的最大距离（Dmaxbulk）和峰值标准摄取值（SUVpeak）。测试IPI和HOVON-84临床PET模型（MTV、Dmaxbulk、SUVpeak、表现状态和年龄）的预测价值。使用曲线下面积（AUC）评估模型表现，并使用阳性预测值（PPV）评估诊断表现。以2年PFS为结局，IPI的AUC为0.62（范围：0.51-0.65）。临床PET模型的AUC显著更高，为0.71（范围：0.59-0.75，p<0.001）。2年TTP也得到了类似的结果。高危IPI患者的2年PFS为61.4%，而高危临床PET患者为51.9%，PPV分别从35.5%升至49.1%。高危IPI患者中有66.4%无进展或复发，而高危临床PET患者中为55.5%，PPV分别从33.7%升至44.6%。在6项独立的一线DLBCL研究中，HOVON-84数据集中开发的临床PET模型仍具有预测结局的能力，并且在所有研究中比目前使用的IPI具有更高的模型表现。版权所有 © 2023美国血液学会。
The objective of this study was to externally validate the clinicalPET model developed in the HOVON-84 trial and to compare the model performance of our clinicalPET model to the international prognostic index (IPI). In total, 1195 Diffuse large B-cell lymphoma patients were included. 887 patients from 6 studies were used as external validation datasets. Primary outcomes were 2-year progression free survival (PFS) and 2-year time to progression (TTP). Metabolic tumor volume (MTV), the maximum distance between the largest lesion and another lesion (Dmaxbulk) and the peak standardized uptake value (SUVpeak) were extracted. The predictive value of the IPI and the HOVON-84 clinicalPET model (MTV, Dmaxbulk, SUVpeak, performance status and age) were tested. Model performance was assessed using the area under the curve (AUC), and diagnostic performance with the positive predictive value (PPV). Using 2-year PFS as outcome, the IPI yielded an AUC of 0.62 (range:0.51-0.65). The clinicalPET model yielded a significantly higher AUC of 0.71 (range:0.59-0.75, p<0.001). Comparable results were found using 2-year TTP. High-risk IPI patients had a 2-year PFS of 61.4%, versus 51.9% for the high-risk clinicalPET patients, with an increase in PPV from 35.5% to 49.1%, respectively. 66.4% of high-risk IPI patients were free from progression or relapse versus 55.5% for high-risk clinicalPET patients, with an increased PPV from 33.7% to 44.6%, respectively. The clinicalPET model that was developed in the HOVON-84 dataset remained predictive of outcome in 6 independent first-line DLBCL studies, and had higher model performance than the currently used IPI in all studies.Copyright © 2023 American Society of Hematology.