The Prognostic Significance of Pontine-White Matter Score in Primary Central Nervous System Lymphoma Patients
by
,
Yongjiang Li
1,†, 
Yiwen Mo
2,†,
Mingshi Chen
3,4,
Wenbiao Zhang
5,
Shuangjiang Li
6 and
Xu Zhang
2,* 1
Department of Nuclear Medicine, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu 610041, China
2
Department of Nuclear Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
3
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
4
Department of Biomedical Engineering and Physics, Amsterdam University Medical Center, 1105 AZ Amsterdam, The Netherlands
5
Department of Radiology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
6
Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Cancers 2024, 16(15), 2708; https://doi.org/10.3390/cancers16152708
Submission received: 20 May 2024
/
Revised: 7 July 2024
/
Accepted: 8 July 2024
/
Published: 30 July 2024
(This article belongs to the Section Methods and Technologies Development)
Simple Summary
This study explored the prognostic significance of the pontine-white matter (PW) score in primary central nervous system (CNS) lymphoma patients with post-treatment 18F-FDG PET/CT and PET/MR imaging. Eligible patients were enrolled from January 2014 to December 2022. The PW score, derived from FDG uptake of the pons and white matter, was used to evaluate the metabolic activity of the treated lesion and its prognostic implications. A total of 90 patients across PET/CT and PET/MR modalities were assessed. The PW score demonstrated a robust discriminative ability in identifying patients with worse outcomes. It was also found to be a significant and independent indicator for worse prognosis in both PET/CT and PET/MR groups. The study demonstrated that this novel internal standardization indicator was an effective tool for risk stratification in primary CNS lymphoma post-treatment scenarios.
Abstract
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-treatment 18F-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.
Keywords:
CNS lymphoma; 18F-FDG PET; prognosis; therapeutic evaluation
