Background: Limited data exist on the significance of PET imaging and quantitative PET parameters in primary central nervous system (CNS) lymphoma due to its relative rarity. This study was conducted to investigate the prognostic value of a novel internal standardization indicator, the pontine-white matter (PW) score, in primary CNS lymphoma patients undergoing post-treatment18F-FDG PET/CT and PET/MR imaging. Methods: From January 2014 to December 2022, eligible patients with primary CNS lymphoma who underwent post-treatment PET imaging were enrolled. Using the FDG uptake of the pons and white matter as an internal reference, the PW score was graded based on the metabolism of the post-therapeutic lesion for each patient, and its associations with patients’ prognosis were investigated. Results: In total, 41 patients with post-treatment PET/CT and 49 patients with post-treatment PET/MR imaging were enrolled. ROC curve analysis indicated that the PW score possessed robust discriminative ability in distinguishing patients with worse outcomes. Furthermore, a higher PW score was significantly correlated with and identified as an independent prognostic indicator for, worse prognosis in both the PET/CT and PET/MR cohorts. Conclusion: The study demonstrated that the PW score was an effective prognostic indicator for identifying post-treatment primary CNS lymphoma patients with worse outcomes.
背景：由于原发性中枢神经系统（CNS）淋巴瘤相对罕见，关于正电子发射断层扫描（PET）成像及其定量参数在该疾病中的意义，现有数据有限。本研究旨在探讨一种新型内部标准化指标——桥脑-白质（PW）评分在接受治疗后18F-FDG PET/CT和PET/MR成像的原发性CNS淋巴瘤患者中的预后价值。方法：自2014年1月至2022年12月，纳入符合条件的接受治疗后PET成像的原发性CNS淋巴瘤患者。以桥脑和白质的FDG摄取为内部参照，根据每位患者治疗后病灶的代谢情况对PW评分进行分级，并探讨其与患者预后的关联。结果：共纳入41例接受治疗后PET/CT成像的患者和49例接受治疗后PET/MR成像的患者。ROC曲线分析表明，PW评分在区分预后较差患者方面具有强大的判别能力。此外，在PET/CT和PET/MR队列中，较高的PW评分均与较差的预后显著相关，并被确定为独立的预后指标。结论：本研究证实，PW评分是识别治疗后预后较差的原发性CNS淋巴瘤患者的有效预后指标。
肿瘤(癌症)患者之家