EJNMMI Research (Oct 2023)

The remodeling of metabolic brain pattern in patients with extracranial diffuse large B-cell lymphoma

  • Junyi Liu,
  • Ming Tang,
  • Dongling Zhu,
  • Ge Ruan,
  • Sijuan Zou,
  • Zhaoting Cheng,
  • Xiaohua Zhu,
  • Yuankai Zhu

DOI
https://doi.org/10.1186/s13550-023-01046-6
Journal volume & issue
Vol. 13, no. 1
pp. 1 – 12

Abstract

Read online

Abstract Background Owing to the advances in diagnosis and therapy, survival or remission rates for lymphoma have improved prominently. Apart from the lymphoma- and chemotherapy-related somatic symptom burden, increasing attention has been drawn to the health-related quality of life. The application of 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) has been routinely recommended for the staging and response assessment of FDG-avid lymphoma. However, up till now, only a few researches have investigated the brain metabolic impairments in patients with pre-treatment lymphoma. The determination of the lymphoma-related metabolic brain pattern would facilitate exploring the tailored therapeutic regimen to alleviate not only the physiological, but also the psychological symptoms. In this retrospective study, we aimed to establish the diffuse large B-cell lymphoma-related pattern (DLBCLRP) of metabolic brain network and investigate the correlations between DLBCLRP and several indexes of the staging and response assessment. Results The established DLBCLRP was characterized by the increased metabolic activity in bilateral cerebellum, brainstem, thalamus, striatum, hippocampus, amygdala, parahippocampal gyrus and right middle temporal gyrus and by the decreased metabolic activity in bilateral occipital lobe, parietal lobe, anterior cingulate gyrus, midcingulate cortex and medial frontal gyrus. Significant difference in the baseline expression of DLBCLRP was found among complete metabolic response (CMR), partial metabolic response (PMR) and progressive metabolic disease (PMD) groups (P 0.05), the post-treatment declines of DLBCLRP expression were significantly positively correlated with Ann Arbor staging (r s = 0.284, P < 0.05) and IPI (r s = 0.297, P < 0.05). Conclusions The proposed DLBCLRP would lay the foundation for further investigating the cerebral dysfunction related to DLBCL itself and/or treatments. Besides, the expression of DLBCLRP was associated with the tumor burden of lymphoma, implying a potential biomarker for prognosis.

Keywords