由于诊断和治疗的进步，淋巴瘤的生存率或缓解率显着提高。除了淋巴瘤和化疗相关的躯体症状负担之外，与健康相关的生活质量也越来越受到关注。 18F-氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描（18F-FDG PET/CT）已被常规推荐用于FDG亲和性淋巴瘤的分期和疗效评估。然而，到目前为止，只有少数研究调查淋巴瘤治疗前患者的脑代谢损伤。确定淋巴瘤相关的大脑代谢模式将有助于探索量身定制的治疗方案，以减轻生理症状和心理症状。在这项回顾性研究中，我们旨在建立代谢脑网络的弥漫性大B细胞淋巴瘤相关模式（DLBCLRP），并探讨DLBCLRP与分期和疗效评估的多个指标之间的相关性。所建立的DLBCLRP的特点是增加双侧小脑、脑干、丘脑、纹状体、海马、杏仁核、海马旁回和右侧颞中回的代谢活动减少，以及双侧枕叶、顶叶、前扣带回、中扣带皮层和内侧额回的代谢活动减少。完全代谢缓解（CMR）组、部分代谢缓解（PMR）组和进行性代谢性疾病（PMD）组之间DLBCLRP基线表达存在显着差异（P<0.01）。 DLBCLRP表达与国际预后指数（IPI）（rs = 0.306，P < 0.05）、lg（总代谢肿瘤体积，TMTV）（r = 0.298，P < 0.05）和lg（总代谢肿瘤体积，TMTV）呈显着或趋于正相关。病变糖酵解，TLG）（r = 0.233，P = 0.064）。虽然DLBCLRP表达与Ann Arbor分期或肿瘤SUVmax无显着相关性(P > 0.05)，但治疗后DLBCLRP表达下降与Ann Arbor分期(rs = 0.284，P < 0.05)和IPI呈显着正相关。 rs = 0.297，P < 0.05）。所提出的DLBCLRP将为进一步研究与DLBCL本身和/或治疗相关的脑功能障碍奠定基础。此外，DLBCLRP 的表达与淋巴瘤的肿瘤负荷相关，这意味着潜在的预后生物标志物。© 2023。作者。

Owing to the advances in diagnosis and therapy, survival or remission rates for lymphoma have improved prominently. Apart from the lymphoma- and chemotherapy-related somatic symptom burden, increasing attention has been drawn to the health-related quality of life. The application of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) has been routinely recommended for the staging and response assessment of FDG-avid lymphoma. However, up till now, only a few researches have investigated the brain metabolic impairments in patients with pre-treatment lymphoma. The determination of the lymphoma-related metabolic brain pattern would facilitate exploring the tailored therapeutic regimen to alleviate not only the physiological, but also the psychological symptoms. In this retrospective study, we aimed to establish the diffuse large B-cell lymphoma-related pattern (DLBCLRP) of metabolic brain network and investigate the correlations between DLBCLRP and several indexes of the staging and response assessment.The established DLBCLRP was characterized by the increased metabolic activity in bilateral cerebellum, brainstem, thalamus, striatum, hippocampus, amygdala, parahippocampal gyrus and right middle temporal gyrus and by the decreased metabolic activity in bilateral occipital lobe, parietal lobe, anterior cingulate gyrus, midcingulate cortex and medial frontal gyrus. Significant difference in the baseline expression of DLBCLRP was found among complete metabolic response (CMR), partial metabolic response (PMR) and progressive metabolic disease (PMD) groups (P < 0.01). DLBCLRP expressions were also significantly or tended to be positively correlated with international prognostic index (IPI) (rs = 0.306, P < 0.05), lg(total metabolic tumor volume, TMTV) (r = 0.298, P < 0.05) and lg(total lesion glycolysis, TLG) (r = 0.233, P = 0.064). Though no significant correlation of DLBCLRP expression was found with Ann Arbor staging or tumor SUVmax (P > 0.05), the post-treatment declines of DLBCLRP expression were significantly positively correlated with Ann Arbor staging (rs = 0.284, P < 0.05) and IPI (rs = 0.297, P < 0.05).The proposed DLBCLRP would lay the foundation for further investigating the cerebral dysfunction related to DLBCL itself and/or treatments. Besides, the expression of DLBCLRP was associated with the tumor burden of lymphoma, implying a potential biomarker for prognosis.© 2023. The Author(s).