A prognostic survival nomogram for persons with extra-nodal natural killer-/T-cell lymphoma

Nomograms referenced by cardiac magnetic resonance in the prediction of cardiac injuries in patients with ST-elevation myocardial infarction

BACKGROUND

Evaluation of cardiac injuries is essential in patients with ST-elevation myocardial infarction (STEMI). Cardiac magnetic resonance (CMR) has become the gold standard for quantifying cardiac injuries; however, its routine application is limited. A nomogram is a useful tool for prognostic prediction based on the comprehensive utilization of clinical data. We presumed that the nomogram models established using CMR as a reference could precisely predict cardiac injuries.

METHODS

This analysis included 584 patients with acute STEMI from a CMR registry study for STEMI (NCT03768453). The patients were divided into training (n = 408) and testing (n = 176) datasets. The least absolute shrinkage and selection operator method and multivariate logistic regression were used to construct nomograms for predicting left ventricular ejection fraction (LVEF) ≤40%, infarction size (IS) ≥ 20% on the LV mass, and microvascular dysfunction.

RESULTS

The nomogram for predicting LVEF≤40%, IS≥20%, and microvascular dysfunction comprised 14, 10, and 15 predictors, respectively. With the nomograms, the individual risk probability of developing specific outcomes could be calculated, and the weight of each risk factor was demonstrated. The C-index of the nomograms in the training dataset were 0.901, 0.831, and 0.814, respectively, and were comparable in the testing set, showing good nomogram discrimination and calibration. The decision curve analysis demonstrated good clinical effectiveness. Online calculators were also constructed.

CONCLUSIONS

With the CMR results as the reference standard, the established nomograms demonstrated good effectiveness in predicting cardiac injuries after STEMI and could provide physicians with a new option for individual risk stratification.

Diagnostic and prognostic value of pretreatment PET/CT in extranodal natural killer/T-cell lymphoma: a retrospective multicenter study

PURPOSE

The objective of this research was to assess the utility of positron emission tomography combined with computed tomography (PET/CT) to detect bone marrow invasion (BMI) and the predictive value of PET/CT in extranodal natural killer/T-cell lymphoma (ENKTL) patients.

PATIENTS AND METHODS

This multicentre study enrolled ENKTL patients who underwent pretherapy PET/CT and bone marrow biopsy (BMB). The specificity, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) of PET/CT and BMB for BMI were evaluated. Multivariate analysis was used to identify predictive parameters for constructing a nomogram.

RESULTS

Seven hundred and forty-eight patients were identified from four hospitals, with eighty (10.7%) having focal skeletal lesions on PET/CT and fifty (6.7%) having positive BMB. When BMB is considered as the gold standard, the specificity, sensitivity, PPV, and NPV of PET/CT for diagnosing BMI were found to be 93.8%, 74.0%, 46.3%, and 98.1%, respectively. PET/CT-positive individuals showed significantly worse OS than PET/CT-negative patients in the subgroup of BMB-negative cases. The nomogram model created according to the significant risk factors from multivariate analysis performed well in predicting survival probability.

CONCLUSION

PET/CT offers a superior degree of precision for determining BMI in ENKTL. A nomogram model including the parameters of PET/CT can predict survival probability and may help in applying appropriate personalized therapy.