Predicting survival, neurotoxicity and response in B-cell lymphoma patients treated with CAR-T therapy using an imaging features-based model

作者：Blanca Ferrer Lores, Alfonso Ortiz-Algarra, Alfonso Picó-Peris, Alejandra Estepa‐Fernández, Fuensanta Bellvís–Bataller, Glen J. Weiss, Almudena Fuster-Matanzo, Juan Pedro Fernández, Ana Jiménez-Pastor, Rafael Hernani, Ana Saus-Carreres, Ana Benzaquén, Laura Ventura, José Luís Piñana, Ana Belén Teruel, Alicia Serrano‐Alcalá, Rosa Dosdá, Pablo Sopena‐Novales, Aitana Balaguer‐Roselló, Manuel Guerreiro, Jaime Sanz, Luis Martí‐Bonmatí, María José Terol, Ángel Alberich‐Bayarri · 发表于：EJNMMI Research · 年份：2024 · DOI：10.1186/s13550-024-01172-9 · 被引用次数：5 · 研究领域：CAR-T cell therapy research、Integrated Circuits and Semiconductor Failure Analysis、Lymphoma Diagnosis and Treatment

This multicentre retrospective observational study aims to develop imaging-based prognostic and predictive models for relapsed/refractory (R/R) B-cell lymphoma patients undergoing CAR-T therapy by integrating clinical data and imaging features. Specifically, our aim was to predict 3- and 6-month treatment response, overall survival (OS), progression-free survival (PFS), and the occurrence of the immune effector cell-associated neurotoxicity syndrome (ICANS). Sixty-five patients of R/R B-cell lymphoma treated with CAR-T cells in two centres were included. Pre-infusion [ 18 F]FDG PET/CT scans and clinical data were systematically collected, and imaging features, including kurtosis, entropy, maximum diameter, standardized uptake value (SUV) related features (SUV max , SUV mean , SUV std , SUV median , SUV p25 , SUV p75 ), total metabolic tumour volume (MTV total ), and total lesion glycolysis (TLG total ), were extracted using the Quibim platform. The median age was 62 (range 21–76) years and the median follow-up for survivors was 10.47 (range 0.20–45.80) months. A logistic regression model accurately predicted neurotoxicity (AUC: 0.830), and Cox proportional-hazards models for CAR-T response at 3 and 6 months demonstrated high accuracy (AUC: 0.754 and 0.818, respectively). Median predicted OS after CAR-T therapy was 4.73 months for high MTV total and 37.55 months for low MTV total . Median predicted PFS was 2.73 months for high MTV total and 11.83 months for low MTV total . For...