KEY TAKEAWAYS
- The study aimed to enhance 18F-FDG PET/CT accuracy for distinguishing lymphoma from EBV-HLH by integrating laboratory parameters.
- Researchers noticed that adding a nomogram to 18F-FDG PET/CT significantly enhances diagnostic accuracy for EBV-HLH and prognosis.
The hyperinflammatory condition and lymphoproliferation due to Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (HLH) affect the detection of lymphomas by 18F-FDG PET/CT.
Xu Yang and the team aimed to improve the diagnostic capabilities of 18F-FDG PET/CT by combining laboratory parameters.
They performed an inclusive analysis of 46 patients diagnosed with EBV-positive HLH who underwent 18F-FDG PET/CT before starting chemotherapy within a 4-year timeframe. The patients were categorized into 2 groups: EBV-associated HLH (EBV-HLH) (n = 31) and EBV-positive lymphoma-associated HLH (EBV + LA-HLH) (n = 15). Multivariable logistic regression and regression tree analysis were employed to develop diagnostic models, and their efficacy in diagnosis and prognosis was assessed.
About the results, a nomogram combining the SUVmax ratio, copies of plasma EBV-DNA, and IFN-γ achieved 100% sensitivity and 81.8% specificity, with an AUC of 0.926 (95% CI, 0.779-0.988). This nomogram also demonstrated predictive power for mortality in patients with EBV-HLH, with a hazard ratio of 4.2 (95% CI, 1.1-16.5). High-risk EBV-HLH patients identified by the nomogram had a similarly unfavorable prognosis as patients with lymphoma.
The study concluded that while 18F-FDG PET/CT alone has limitations in differentiating between lymphoma and EBV-HLH in patients with active EBV infection, the integration of a nomogram significantly improves diagnostic accuracy and demonstrates a strong association with prognostic outcomes.
This study was funded by the National Natural Science Foundation of China (No: 81971642, 82001861, 82102088), National Key Research and Development Plan (No: 2020YFC0122000), China National Postdoctoral Program (GZC20231753), and Beijing Friendship Hospital Seed Project of Capital Medical University (YYZZ202338).
Source: https://pubmed.ncbi.nlm.nih.gov/39155389/
Yang X, Lu X, Feng L, et al. (2024). “Enhancing diagnostic precision in EBV-related HLH: a multifaceted approach using 18F-FDG PET/CT and nomogram integration.” Cancer Imaging. 2024 Aug 18;24(1):108. doi: 10.1186/s40644-024-00757-w. PMID: 39155389.
