Brenner Winfried, Friedrich Reinhard E, Gawad Karim A, Hagel Christian, von Deimling Andreas, de Wit Maike, Buchert Ralph, Clausen Malte, Mautner Victor F
Department of Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
Eur J Nucl Med Mol Imaging. 2006 Apr;33(4):428-32. doi: 10.1007/s00259-005-0030-1. Epub 2006 Jan 11.
In patients with neurofibromatosis type-1 (NF1) and malignant peripheral nerve sheath tumours (MPNSTs), survival rates are low and time to death is often less than 2 years. However, there are patients with a more favourable prognosis who develop metastases rather late or not at all. Since histopathology and tumour grading are not well correlated with prognosis, we aimed to evaluate the potential of (18)F-fluorodeoxyglucose positron emission tomography (FDG PET) for prediction of patient outcome in MPNST.
FDG PET was performed in 16 patients with NF1 and MPNSTs. Standardised uptake values (SUVs) were calculated for each tumour and correlated to tumour grade and patient outcome in terms of survival or death.
Three patients with tumour grade II had an SUV <3. None of these patients developed metastases or died during a follow-up of 41-62 months. Thirteen patients with tumour grades II and III had an SUV >3. Only one of these patients is still alive after 20 months; the remaining 12 died within 4-33 months. SUV predicted long-term survival with an accuracy of 94%, compared with 69% for tumour grade. In Kaplan-Meier survival analysis, patients with an SUV >3 had a significantly shorter mean survival time, 13 months, than patients with an SUV <3, in whom the mean survival time was 52 months. Tumour grading did not reveal differences in survival time (15 vs 12 months).
Tumour SUV obtained by FDG PET was a significant parameter for prediction of survival in NF1 patients with MPNSTs while histopathological tumour grading did not predict outcome.
1型神经纤维瘤病（NF1）合并恶性外周神经鞘瘤（MPNST）患者的生存率较低，死亡时间通常不足2年。然而，有部分患者预后较好，发生转移较晚或根本不发生转移。由于组织病理学和肿瘤分级与预后的相关性不佳，我们旨在评估18F-氟脱氧葡萄糖正电子发射断层扫描（FDG PET）预测MPNST患者预后的潜力。
对16例NF1合并MPNST患者进行了FDG PET检查。计算每个肿瘤的标准化摄取值（SUV），并将其与肿瘤分级以及患者的生存或死亡结局相关联。
3例肿瘤分级为II级的患者SUV<3。在41-62个月的随访期间，这些患者均未发生转移或死亡。13例肿瘤分级为II级和III级的患者SUV>3。这些患者中只有1例在20个月后仍存活；其余12例在4-33个月内死亡。SUV预测长期生存的准确率为94%，而肿瘤分级的准确率为69%。在Kaplan-Meier生存分析中，SUV>3的患者平均生存时间明显较短，为13个月，而SUV<3的患者平均生存时间为52个月。肿瘤分级未显示出生存时间的差异（15个月对12个月）。
通过FDG PET获得的肿瘤SUV是预测NF1合并MPNST患者生存的重要参数，而组织病理学肿瘤分级不能预测结局。
