Nuclear Medicine, Scientific Institute San Raffaele, via Olgettina, 60, 20132, Milan, Italy,
Eur J Nucl Med Mol Imaging. 2014 Jan;41(1):21-31. doi: 10.1007/s00259-013-2528-2. Epub 2013 Aug 29.
The aim of this study was to evaluate the predictive role of pre-therapy fluorodeoxyglucose (FDG) uptake parameters of primary tumour in head and neck cancer (HNC) patients undergoing intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) on FDG-positive volume-positron emission tomography (PET) gross tumour volume (PET-GTV).
This retrospective study included 19 patients (15 men and 4 women, mean age 59.2 years, range 23-81 years) diagnosed with HNC between 2005 and 2011. Of 19 patients, 15 (79 %) had stage III-IV. All patients underwent FDG PET/CT before treatment. Metabolic indexes of primary tumour, including metabolic tumour volume (MTV), maximum and mean standardized uptake value (SUVmax, SUVmean) and total lesion glycolysis (TLG) were considered. Partial volume effect correction (PVC) was performed for SUVmean and TLG estimation. Correlations between PET/CT parameters and 2-year disease-free survival (DFS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) were assessed. Median patient follow-up was 19.2 months (range 4-24 months).
MTV, TLG and PVC-TLG predicting patients' outcome with respect to all the considered local and distant disease control endpoints (LRFS, DMFS and DFS) were 32.4 cc, 469.8 g and 547.3 g, respectively. SUVmean and PVC-SUVmean cut-off values predictive of LRFS and DFS were 10.8 and 13.3, respectively. PVC was able to compensate errors up to 25 % in the primary HNC tumour uptake. Moreover, PVC enhanced the statistical significance of the results.
FDG PET/CT uptake parameters are predictors of patients' outcome and can potentially identify patients with higher risk of treatment failure that could benefit from more aggressive approaches. Application of PVC is recommended for accurate measurement of PET parameters.
本研究旨在评估在行调强放疗（IMRT）同步整合推量（SIB）的头颈部癌（HNC）患者中，原发肿瘤治疗前氟脱氧葡萄糖（FDG）摄取参数对 FDG 阳性体积正电子发射断层扫描（PET）大体肿瘤体积（PET-GTV）的预测作用。
本回顾性研究纳入了 19 例（男 15 例，女 4 例，平均年龄 59.2 岁，范围 23-81 岁）2005 年至 2011 年间诊断为 HNC 的患者。19 例患者中，15 例（79%）为 III-IV 期。所有患者均在治疗前接受 FDG PET/CT 检查。考虑了原发肿瘤的代谢指标，包括代谢肿瘤体积（MTV）、最大和平均标准化摄取值（SUVmax、SUVmean）和总病灶糖酵解（TLG）。进行了 SUVmean 和 TLG 估算的部分容积效应校正（PVC）。评估了 PET/CT 参数与 2 年无疾病生存（DFS）、局部无复发生存（LRFS）和远处无转移生存（DMFS）之间的相关性。中位患者随访时间为 19.2 个月（范围 4-24 个月）。
MTV、TLG 和 PVC-TLG 分别为 32.4cc、469.8g 和 547.3g，预测了所有考虑的局部和远处疾病控制终点（LRFS、DMFS 和 DFS）的患者结局。SUVmean 和 PVC-SUVmean 预测 LRFS 和 DFS 的截断值分别为 10.8 和 13.3。PVC 可补偿原发 HNC 肿瘤摄取中高达 25%的误差。此外，PVC 增强了结果的统计学意义。
FDG PET/CT 摄取参数是患者结局的预测因子，可能能够识别出治疗失败风险较高的患者，这些患者可能受益于更积极的治疗方法。推荐应用 PVC 以准确测量 PET 参数。
