Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea.
Eur J Nucl Med Mol Imaging. 2013 Dec;40(12):1836-42. doi: 10.1007/s00259-013-2511-y. Epub 2013 Jul 24.
Preoperative identification of aggressiveness is important for the establishment of a treatment strategy in patients with soft-tissue sarcoma (STS). We compared the predictive values of various metabolic parameters derived from PET/CT with (18)F-FDG, including maximal standardized uptake value (SUVmax), total lesion glycolysis (TLG) and metabolic tumour volume (MTV).
A total of 66 patients with STS who had undergone FDG PET/CT before tumour resection were reviewed retrospectively. We determined SUVmax, TLG and MTV to compare their value in predicting disease progression, which was defined as local recurrence and metastases. Receiver operating characteristic curve (ROC) analysis was used to compare the accuracy. Univariate and multivariate analyses of conventional clinicopathological variables were used to compare the reliability of the metabolic parameters.
TLG exhibited greater accuracy than SUVmax or MTV in ROC analysis (area under curve, AUC, 0.802, 0.726 and 0.681, respectively). The cut-off values for disease progression derived from the AUC data were TLG 250; SUVmax 6.0, and MTV 40 cm(3). In univariate analysis, TLG (>250) was a more significant predictive factor than SUVmax and MTV (P < 0.001, P = 0.031 and P = 0.022, respectively). TLG was the only meaningful metabolic parameter in the multivariate analysis (P = 0.008) other than presence of metastasis at diagnosis (P = 0.003).
TLG is a more accurate predictor of disease progression than SUVmax or MTV. TLG enables accurate preoperative assessment of aggressiveness comparable with conventional clinicopathological parameters.
术前识别侵袭性对于软组织肉瘤（STS）患者治疗策略的制定非常重要。我们比较了来自 FDG PET/CT 的各种代谢参数（包括最大标准化摄取值[SUVmax]、总病灶糖酵解[TLG]和代谢肿瘤体积[MTV]）的预测值。
回顾性分析了 66 例在肿瘤切除前接受 FDG PET/CT 的 STS 患者。我们测定了 SUVmax、TLG 和 MTV，以比较它们在预测疾病进展（定义为局部复发和转移）方面的价值。使用受试者工作特征曲线（ROC）分析比较准确性。使用单变量和多变量分析比较常规临床病理变量的可靠性。
在 ROC 分析中，TLG 的准确性大于 SUVmax 或 MTV（曲线下面积[AUC]，分别为 0.802、0.726 和 0.681）。从 AUC 数据得出的疾病进展的截断值为 TLG 250；SUVmax 为 6.0，MTV 为 40 cm3。在单变量分析中，TLG（>250）比 SUVmax 和 MTV 更具有预测价值（P < 0.001、P = 0.031 和 P = 0.022）。除了初诊时存在转移（P = 0.003）外，TLG 是多变量分析中唯一有意义的代谢参数（P = 0.008）。
TLG 是疾病进展的预测指标，比 SUVmax 或 MTV 更准确。TLG 能够准确地对术前侵袭性进行评估，与常规临床病理参数相当。
