¹⁸F-FDG-PET 影像学特征预测食管癌新辅助放化疗病理反应。
Spatial-temporal [¹⁸F]FDG-PET features for predicting pathologic response of esophageal cancer to neoadjuvant chemoradiation therapy.
机构信息
Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
出版信息
Int J Radiat Oncol Biol Phys. 2013 Apr 1;85(5):1375-82. doi: 10.1016/j.ijrobp.2012.10.017. Epub 2012 Dec 6.
PURPOSE
To extract and study comprehensive spatial-temporal (18)F-labeled fluorodeoxyglucose ([(18)F]FDG) positron emission tomography (PET) features for the prediction of pathologic tumor response to neoadjuvant chemoradiation therapy (CRT) in esophageal cancer.
METHODS AND MATERIALS
Twenty patients with esophageal cancer were treated with trimodal therapy (CRT plus surgery) and underwent [(18)F]FDG-PET/CT scans both before (pre-CRT) and after (post-CRT) CRT. The 2 scans were rigidly registered. A tumor volume was semiautomatically delineated using a threshold standardized uptake value (SUV) of ≥2.5, followed by manual editing. Comprehensive features were extracted to characterize SUV intensity distribution, spatial patterns (texture), tumor geometry, and associated changes resulting from CRT. The usefulness of each feature in predicting pathologic tumor response to CRT was evaluated using the area under the receiver operating characteristic curve (AUC) value.
RESULTS
The best traditional response measure was decline in maximum SUV (SUVmax; AUC, 0.76). Two new intensity features, decline in mean SUV (SUVmean) and skewness, and 3 texture features (inertia, correlation, and cluster prominence) were found to be significant predictors with AUC values ≥0.76. According to these features, a tumor was more likely to be a responder when the SUVmean decline was larger, when there were relatively fewer voxels with higher SUV values pre-CRT, or when [(18)F]FDG uptake post-CRT was relatively homogeneous. All of the most accurate predictive features were extracted from the entire tumor rather than from the most active part of the tumor. For SUV intensity features and tumor size features, changes were more predictive than pre- or post-CRT assessment alone.
CONCLUSION
Spatial-temporal [(18)F]FDG-PET features were found to be useful predictors of pathologic tumor response to neoadjuvant CRT in esophageal cancer.
目的
提取并研究综合时空（18）F-氟代脱氧葡萄糖（[（18）F]FDG）正电子发射断层扫描（PET）特征，以预测食管癌新辅助放化疗（CRT）的病理肿瘤反应。
方法与材料
20 例食管癌患者接受三联治疗（CRT 加手术），并在 CRT 前后进行[（18）F]FDG-PET/CT 扫描。两次扫描均进行刚性配准。使用阈值标准化摄取值（SUV）≥2.5 半自动描绘肿瘤体积，然后进行手动编辑。提取综合特征以描述 SUV 强度分布、空间模式（纹理）、肿瘤几何形状以及 CRT 引起的相关变化。使用受试者工作特征曲线（AUC）值评估每个特征预测 CRT 对肿瘤病理反应的有用性。
结果
最佳传统反应指标是最大 SUV（SUVmax）下降（AUC，0.76）。发现两个新的强度特征，即平均 SUV（SUVmean）下降和偏度，以及 3 个纹理特征（惯性、相关性和聚类突出度）是具有 AUC 值≥0.76 的显著预测因子。根据这些特征，如果 SUVmean 下降较大、CRT 前具有较高 SUV 值的体素相对较少，或者 CRT 后[（18）F]FDG 摄取相对均匀，则肿瘤更有可能是 responder。所有最准确的预测特征均从整个肿瘤中提取，而不是从肿瘤最活跃的部分提取。对于 SUV 强度特征和肿瘤大小特征，变化比单独的预 CRT 或 post-CRT 评估更具预测性。
结论
时空[（18）F]FDG-PET 特征可作为预测食管癌新辅助 CRT 病理肿瘤反应的有用指标。
Zotero 插件