使用 18F-FDG PET/CT 和容积灌注 CT 对非小细胞肺癌进行多功能分析。

Multifunctional profiling of non-small cell lung cancer using 18F-FDG PET/CT and volume perfusion CT.

机构信息

Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen, Germany.

出版信息

J Nucl Med. 2012 Apr;53(4):521-9. doi: 10.2967/jnumed.111.097865. Epub 2012 Mar 13.

DOI:10.2967/jnumed.111.097865

PMID:22414637

Abstract

UNLABELLED

The aim of this study was to investigate correlations between glucose metabolism registered by (18)F-FDG PET/CT and tumor perfusion quantified by volume perfusion CT and immunohistochemical markers Ki67 and microvessel density (MVD) in patients with non-small cell lung cancer (NSCLC).

METHODS

Between February 2010 and April 2011, 24 consecutive patients (21 women, 3 men; mean age ± SD, 67.6 ± 6.8 y; age range, 55.6-81.3 y) with histologically proven NSCLC (14 adenocarcinoma, 9 squamous cell lung carcinoma [SCC], and 1 mixed adenocarcinoma and SCC) underwent (18)F-FDG PET/CT and additional volume perfusion CT. Maximum standardized uptake value (SUV(max)), mean SUV, and the metabolic tumor volume were used for (18)F-FDG uptake quantification. Blood flow (BF), blood volume (BV), flow extraction product (K(trans)), and standardized perfusion value (SPV) were determined as CT perfusion parameters. Both perfusion parameters and (18)F-FDG uptake values were subsequently related to the histologic subtypes, proliferation marker Ki67, MVD according to CD34 staining, and total tumor volume.

RESULTS

Mean SUV, SUV(max), and the metabolic tumor volume (mL) were 5.8, 8.7, and 32.3, respectively, in adenocarcinoma and 8.5, 12.9, and 16.8, respectively, in SCC. Mean BF (mL/100 mL/min), mean BV (mL/100 mL), and K(trans) (mL/100 mL/min) were 35.4, 7.3, and 27.8, respectively, in adenocarcinoma and 35.5, 10.0, and 27.8, respectively, in SCC. Moderate correlations were found between the (18)F-FDG PET/CT parameters and Ki67 as well as between CT perfusion parameters and MVD but not vice versa. For all tumors, the following correlations were found: between SUV(max) and Ki67, r = 0.762 (P = 0.017); between SUV(max) and MVD, r = -0.237 (P = 0.359); between mean BF and Ki67, r = -0.127 (P = 0.626); and between mean BF and MVD, r = 0.467 (P = 0.059). Interestingly, correlations between the BF-metabolic relationship and total tumor volume were higher in SCC (r = 0.762, P = 0.017) than in adenocarcinoma (r = -0.0791, P = 0.788).

CONCLUSION

(18)F-FDG uptake correlates with Ki67, whereas BF, BV, and K(trans) correlate with MVD. Therefore, (18)F-FDG uptake and perfusion parameters provide complementary functional information. An improved tumor profiling will be beneficial for both prognosis and therapy response evaluation in these tumors.

摘要

目的

本研究旨在探讨非小细胞肺癌（NSCLC）患者中，葡萄糖代谢的（18）F-FDG PET/CT 与体积灌注 CT 量化的肿瘤灌注之间的相关性，并与 Ki67 免疫组化标志物和微血管密度（MVD）进行相关性分析。

方法

2010 年 2 月至 2011 年 4 月，连续 24 例经组织学证实的 NSCLC 患者（21 名女性，3 名男性；平均年龄±标准差，67.6±6.8 岁；年龄范围 55.6-81.3 岁）接受了（18）F-FDG PET/CT 和额外的体积灌注 CT。最大标准化摄取值（SUV（max））、平均 SUV 和代谢肿瘤体积用于（18）F-FDG 摄取定量。血流（BF）、血容量（BV）、血流提取产物（K（trans））和标准化灌注值（SPV）被确定为 CT 灌注参数。随后将灌注参数和（18）F-FDG 摄取值与组织学亚型、增殖标志物 Ki67、根据 CD34 染色的 MVD 以及总肿瘤体积相关联。

结果

腺癌的平均 SUV、SUV（max）和代谢肿瘤体积（mL）分别为 5.8、8.7 和 32.3，而 SCC 分别为 8.5、12.9 和 16.8。平均 BF（mL/100 mL/min）、平均 BV（mL/100 mL）和 K（trans）（mL/100 mL/min）分别为 35.4、7.3 和 27.8，而 SCC 分别为 35.5、10.0 和 27.8。在（18）F-FDG PET/CT 参数与 Ki67 之间以及 CT 灌注参数与 MVD 之间发现了中度相关性，但反之不然。对于所有肿瘤，发现了以下相关性：SUV（max）与 Ki67 之间，r=0.762（P=0.017）；SUV（max）与 MVD 之间，r=-0.237（P=0.359）；BF 均值与 Ki67 之间，r=-0.127（P=0.626）；BF 均值与 MVD 之间，r=0.467（P=0.059）。有趣的是，SCC 中 BF-代谢关系与总肿瘤体积之间的相关性高于腺癌（r=0.762，P=0.017）。