Nuclear Medicine Service, Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Clin Cancer Res. 2010 Dec 15;16(24):6093-9. doi: 10.1158/1078-0432.CCR-10-1357. Epub 2010 Oct 25.
To compare the diagnostic and prognostic value of [(18)F] fluorodeoxyglucose positron emission tomography (FDG-PET) and bone scans (BS) in the assessment of osseous lesions in patients with progressing prostate cancer.
In a prospective imaging trial, 43 patients underwent FDG-PET and BS prior to experimental therapies. Bone scan index (BSI) and standardized uptake value (SUV) on FDG-PET were recorded. Patients were followed until death (n = 36) or at least 5 years (n = 7). Imaging findings were correlated with survival.
Osseous lesions were detected in 39 patients on BS and 32 on FDG-PET (P = 0.01). Follow-up was available for 105 FDG-positive lesions, and 84 (80%) became positive on subsequent BS. Prognosis correlated inversely with SUV (median survival 14.4 versus 32.8 months if SUVmax > 6.10 versus ≤ 6.10; P = 0.002) and BSI (14.7 versus 28.2 months if BSI > 1.27 versus < 1.27; P = 0.004). Only SUV was an independent factor in multivariate analysis.
This study of progressive prostate cancer confirms earlier work that BSI is a strong prognostic factor. Most FDG-only lesions at baseline become detectable on follow-up BS, suggesting their strong clinical relevance. FDG SUV is an independent prognostic factor and provides complementary prognostic information.
比较 [(18)F] 氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）和骨扫描（BS）在评估进展性前列腺癌患者骨病变中的诊断和预后价值。
在一项前瞻性影像学试验中，43 名患者在接受实验性治疗前接受了 FDG-PET 和 BS。记录了骨扫描指数（BSI）和 FDG-PET 的标准化摄取值（SUV）。患者随访至死亡（n=36）或至少 5 年（n=7）。将影像学发现与生存相关联。
BS 检测到 39 例患者有骨病变，FDG-PET 检测到 32 例（P=0.01）。对 105 个 FDG 阳性病变进行了随访，其中 84 个（80%）在随后的 BS 上呈阳性。SUVmax>6.10 与 SUVmax≤6.10 的患者预后呈负相关（中位生存时间分别为 14.4 个月和 32.8 个月；P=0.002）和 BSI（BSI>1.27 与 BSI<1.27 的患者中位生存时间分别为 14.7 个月和 28.2 个月；P=0.004）。仅 SUV 是多变量分析中的独立因素。
本研究证实了早期研究结果，即 BSI 是一个强有力的预后因素。大多数基线时仅 FDG 阳性的病变在随访 BS 上变得可检测，这表明其具有很强的临床相关性。FDG SUV 是一个独立的预后因素，并提供了补充的预后信息。
