CT 纹理特征与基于体积的 PET 参数相较于血清学标志物在预测接受 CD19-CAR-T 细胞治疗的弥漫大 B 细胞淋巴瘤患者疗效中的价值

The goal of this study was to investigate the value of CT-textural features and volume-based PET parameters in comparison to serologic markers for response prediction in patients with diffuse large B-cell lymphoma (DLBCL) undergoing cluster of differentiation (CD19)-chimeric antigen receptor (CAR)-T cell therapy.

We retrospectively analyzed the whole-body (WB)-metabolic tumor volume (MTV), the WB-total lesion glycolysis (TLG) and first order textural features derived from 18F-FDG-PET/CT, as well as serologic parameters (C-reactive protein [CRP] and lactate dehydrogenase [LDH], leucocytes) prior and after CAR-T cell therapy in 21 patients with DLBCL (57. 7 14. 7 year; 7 female). Interleukin 6 (IL-6) and IL-2 receptor peaks were monitored after treatment onset and compared with patient outcome judged by follow-up 18F-FDG-PET/CT. In 12/21 patients (57%), complete remission (CR) was observed, whereas 9/21 patients (43%) showed partial remission (PR).

At baseline, WB-MTV and WB-TLG were lower in patients achieving CR (35 38 mL and 319 362) compared to patients achieving PR (88 110 mL and 1487 2254; p < 0. 05). The entropy proved lower (1. 81 0. 09) and uniformity higher (0. 33 0. 02) in patients with CR compared to PR (2. 08 0. 22 and 0. 28 0. 47; p < 0. 05).

Patients achieving CR had lower levels of CRP, LDH and leucocytes at baseline compared to patients achieving PR (p < 0. 05). In the entire cohort, WB-MTV and WB-TLG decreased after therapy onset (p < 0. 01) becoming not measurable in the CR-group. Leucocytes and CRP significantly dropped after therapy (p < 0. 01). The IL-6 and IL-2R peaks after therapy were lower in patients with CR compared to PR (p > 0. 05).

In conclusion, volume-based PET parameters derived from PET/CT and CT-textural features have the potential to predict therapy response in patients with DLBCL undergoing CAR-T cell therapy.