Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Eur J Radiol. 2014 Jan;83(1):219-25. doi: 10.1016/j.ejrad.2013.09.004. Epub 2013 Sep 17.
Purpose of the present study was to evaluate the role of (18)F-FDOPA PET/CT for predicting survival in patients with suspected recurrent glioma.
A total of 33 previously treated, histopathologically proven glioma patients with clinical and contrast enhanced MRI findings suspicious for recurrence were enrolled in this prospective study. All patients underwent (18)F-FDOPA PET/CT. Ratios of tumor uptake to normal tissue uptake were generated by dividing the tumor SUVmax with SUVmax of the contralateral normal brain tissue (T/N), normal striatum (T/S), normal white matter (T/W) and normal cerebellum (T/C). Patients were followed up clinically and by repeated imaging. Data was censored, if the patient died of disease or at the end of the study. Survival analysis was performed for the distributions of each variable and by multivariate analysis.
(18)F-FDOPA PET/CT was positive for recurrence in 25 patients and negative in 8. Death occurred in nineteen patients. Median follow up period was 20.2 months. Median survival in this study was 39.2 months. In univariate analysis significant association of survival was noted with results of (18)F-FDOPA PET/CT (P=0.007) and (18)F-FDOPA PET/CT quantitative parameters namely SUVmax (P=0.001), T/S (P=0.005), T/W (P=0.0004), T/N (P=0.001) and T/C (P=0.003) were found to be significant. On multivariate analysis, only MRI size of the recurrent tumor (P=0.002) and T/N ratio of (18)F-FDOPA PET/CT (P=0.005) were found to be independent predictors of survival.
T/N ratio on (18)F-FDOPA PET/CT is an independent predictor of survival in patients with suspected recurrent glioma, along with size of recurrent tumor on MRI.
目的 本研究旨在评估 18F-FDOPA PET/CT 在预测疑似复发性脑胶质瘤患者生存中的作用。
方法 共纳入 33 例经组织病理学证实的复发性脑胶质瘤患者，这些患者先前经过治疗，且临床和对比增强 MRI 检查均显示疑似复发。所有患者均接受 18F-FDOPA PET/CT 检查。通过将肿瘤 SUVmax 除以对侧正常脑组织（T/N）、正常纹状体（T/S）、正常白质（T/W）和正常小脑（T/C）的 SUVmax 来生成肿瘤摄取与正常组织摄取的比值。对患者进行临床和重复影像学随访。如果患者死于疾病或研究结束，则对数据进行删失。对各变量的分布及多变量分析进行生存分析。
结果 25 例患者的 18F-FDOPA PET/CT 检查结果为阳性，8 例患者为阴性。19 例患者死亡。中位随访时间为 20.2 个月。本研究的中位生存期为 39.2 个月。单因素分析显示，18F-FDOPA PET/CT 检查结果（P=0.007）和 18F-FDOPA PET/CT 定量参数（即 SUVmax、T/S、T/W、T/N 和 T/C）与生存显著相关（P 值分别为 0.001、0.005、0.0004、0.001 和 0.003）。多因素分析显示，仅复发肿瘤的 MRI 大小（P=0.002）和 18F-FDOPA PET/CT 的 T/N 比值（P=0.005）是生存的独立预测因素。
结论 18F-FDOPA PET/CT 的 T/N 比值与 MRI 上复发性肿瘤的大小一样，是预测疑似复发性脑胶质瘤患者生存的独立预测因子。
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