Implications of Sarcopenia and Glucometabolism Parameters of Muscle Derived From Baseline and End-of-Treatment 18F-FDG PET/CT in Diffuse Large B-Cell Lymphoma.

IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Korean Journal of Radiology Pub Date : 2024-03-01 DOI:10.3348/kjr.2023.0949
Xiaoyue Tan, Xiaolin Sun, Yang Chen, Fanghu Wang, Yuxiang Shang, Qing Zhang, Hui Yuan, Lei Jiang
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Abstract

Objective: We previously found that the incidence of sarcopenia increased with declining glucose metabolism of muscle in patients with treatment-naïve diffuse large B-cell lymphoma (DLBCL). This study aimed to investigate the relationship between sarcopenia and muscle glucometabolism using 18F-FDG PET/CT at baseline and end-of-treatment, analyze the changes in these parameters through treatment, and assess their prognostic values.

Materials and methods: The records of 103 patients with DLBCL (median 54 years [range, 21-76]; male:female, 50:53) were retrospectively reviewed. Skeletal muscle area at the third lumbar vertebral (L3) level was measured, and skeletal muscle index (SMI) was calculated to determine sarcopenia, defined as SMI < 44.77 cm²/m² and < 32.50 cm²/m² for male and female, respectively. Glucometabolic parameters of the psoas major muscle, including maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean), were measured at L3 as well. Their changes across treatment were also calculated as ΔSMI, ΔSUVmax, and ΔSUVmean; Δbody mass index was also calculated. Associations between SMI and the metabolic parameters were analyzed, and their associations with progression-free survival (PFS) and overall survival (OS) were identified.

Results: The incidence of sarcopenia was 29.1% and 36.9% before and after treatment, respectively. SMI (P = 0.004) was lower, and sarcopenia was more frequent (P = 0.011) at end-of-treatment than at baseline. The SUVmax and SUVmean of muscle were lower (P < 0.001) in sarcopenia than in non-sarcopenia at both baseline and end-of-treatment. ΔSMI was positively correlated with ΔSUVmax of muscle (P = 0.022). Multivariable Cox regression analysis showed that sarcopenia at end-of-treatment was independently negatively associated with PFS (adjusted hazard ratio [95% confidence interval], 2.469 [1.022-5.965]), while sarcopenia at baseline was independently negatively associated with OS (5.051 [1.453-17.562]).

Conclusion: Sarcopenic patients had lower muscle glucometabolism, and the muscular and metabolic changes across treatment were positively correlated. Sarcopenia at baseline and end-of-treatment was negatively associated with the prognosis of DLBCL.

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从弥漫大 B 细胞淋巴瘤基线和治疗末期 18F-FDG PET/CT 中得出的肌肉 Sarcopenia 和糖代谢参数的影响
研究目的我们曾发现,在弥漫大 B 细胞淋巴瘤(DLBCL)治疗无效的患者中,肌肉疏松症的发生率随着肌肉葡萄糖代谢的下降而增加。本研究旨在利用 18F-FDG PET/CT 研究基线和治疗末期肌肉疏松症与肌肉糖代谢之间的关系,分析这些参数在治疗过程中的变化,并评估其预后价值:回顾性分析103例DLBCL患者(中位年龄54岁[范围21-76];男女比例50:53)的病历。测量第三腰椎(L3)水平的骨骼肌面积,计算骨骼肌指数(SMI)以确定肌肉疏松症,男性和女性的SMI分别为< 44.77 cm²/m²和< 32.50 cm²/m²。腰大肌的糖代谢参数,包括最大标准化摄取值(SUVmax)和平均标准化摄取值(SUVmean),也在 L3 进行了测量。此外,还计算了ΔSMI、ΔSUVmax 和 ΔSUVmean,以及Δ体重指数。分析了 SMI 与代谢参数之间的关系,并确定了它们与无进展生存期(PFS)和总生存期(OS)之间的关系:结果:治疗前后,肌肉疏松症的发生率分别为 29.1%和 36.9%。与基线相比,治疗结束时的SMI(P = 0.004)更低,而肌肉疏松症的发生率更高(P = 0.011)。在基线和治疗结束时,肌肉疏松症患者的肌肉 SUVmax 和 SUVmean 均值均低于非肌肉疏松症患者(P < 0.001)。ΔSMI与肌肉的ΔSUVmax呈正相关(P = 0.022)。多变量考克斯回归分析显示,治疗结束时的肌肉疏松症与PFS呈负相关(调整后危险比[95%置信区间]为2.469 [1.022-5.965]),而基线时的肌肉疏松症与OS呈负相关(5.051 [1.453-17.562]):结论:肌肉疏松症患者的肌肉糖代谢较低,治疗过程中肌肉和代谢的变化呈正相关。基线和治疗结束时的肌肉疏松症与 DLBCL 的预后呈负相关。
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来源期刊
Korean Journal of Radiology
Korean Journal of Radiology 医学-核医学
CiteScore
10.60
自引率
12.50%
发文量
141
审稿时长
1.3 months
期刊介绍: The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.
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