Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-040, South Korea.
World J Gastroenterol. 2012 Jul 7;18(25):3215-22. doi: 10.3748/wjg.v18.i25.3215.
To investigate the correlation of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) with clinical features and the prediction of treatment response.
A total of 83 hepatocellular carcinoma (HCC) patients undergoing ¹⁸F-FDG PET before transarterial chemolipiodolization with systemic chemo-infusion between October, 2006 and May, 2009 were retrospectively enrolled. The patients included 68 men and 15 women (mean age, 60 ± 10.7 years). The effect of (18)F-FDG-monitored PET uptake on clinical features and on the evaluated treatment response was ascertained with modified Response Evaluation Criteria in Solid Tumors. The PET parameters of maximal standardized uptake value of the tumor (Tsuv(max)), the ratio of the tumor maximal standardized uptake value (SUV) to the liver maximal SUV (Tsuv(max)/Lsuv(max)) and the ratio of tumor maximal SUV to the liver mean SUV (Tsuv(max)/Lsuv(mean)) were tested as predictive factors.
Among the 3 SUV parameters, the Tsuv(max)/Lsuv(mean) ratio (cutoff value of 1.90) was significantly associated with tumor burden including tumor size, tumor number, α-fetoprotein levels and tumor stage (P < 0.001, P = 0.008, P = 0.011, P < 0.001, respectively). The objective response rates in patients with a high SUV ratio (≥ 1.90) were significantly better than those with a low SUV ratio (< 1.90) (P = 0.020). The overall survival rates of patients exhibiting a low Tsuv(max)/Lsuv(mean) ratio (< 1.90) and those with a high SUV ratio (≥ 1.90) was 38.2 and 10.3 mo, respectively (P < 0.01). However, the time to progression showed no significant difference between the groups (P = 0.15).
¹⁸F-FDG PET can be an important predictor of HCC treatment. In particular, the Tsuv(max)/Lsuv(mean) ratio (cutoff value of 1.90) can provide useful information in treatment prognosis for HCC patients treated with locoregional therapy.
探讨 ¹⁸F-氟代脱氧葡萄糖（¹⁸F-FDG）正电子发射断层扫描（PET）与临床特征的相关性及其对治疗反应的预测价值。
回顾性分析 2006 年 10 月至 2009 年 5 月期间 83 例行经动脉化疗栓塞联合全身化疗的肝细胞癌（HCC）患者的¹⁸F-FDG PET 资料。患者均为男性 68 例，女性 15 例，平均年龄为 60±10.7 岁。采用实体瘤疗效评价标准（mRECIST）评估治疗效果，探讨¹⁸F-FDG-PET 摄取与临床特征及治疗效果的相关性。通过最大标准化摄取值（Tsuv(max)）、肿瘤最大标准化摄取值与肝脏最大标准化摄取值的比值（Tsuv(max)/Lsuv(max)）和肿瘤最大标准化摄取值与肝脏平均标准化摄取值的比值（Tsuv(max)/Lsuv(mean)）等 PET 参数预测治疗效果。
3 个 SUV 指标中，Tsuv(max)/Lsuv(mean)比值（截断值为 1.90）与肿瘤负荷包括肿瘤大小、肿瘤数量、甲胎蛋白水平和肿瘤分期显著相关（P＜0.001，P=0.008，P=0.011，P＜0.001）。Tsuv(max)/Lsuv(mean)比值较高（≥1.90）的患者客观缓解率显著优于比值较低（＜1.90）的患者（P=0.020）。Tsuv(max)/Lsuv(mean)比值较低（＜1.90）的患者总生存时间为 38.2 个月，比值较高（≥1.90）的患者总生存时间为 10.3 个月，两组比较差异有统计学意义（P＜0.01）。但两组疾病进展时间差异无统计学意义（P=0.15）。
¹⁸F-FDG PET 是预测 HCC 治疗效果的重要指标，其中 Tsuv(max)/Lsuv(mean)比值（截断值为 1.90）可提供局部区域治疗的 HCC 患者治疗预后的有用信息。
