18F-FDG PET/CT 参数与直肠癌患者病理结果的相关性。
Correlations between 18F-FDG PET/CT parameters and pathological findings in patients with rectal cancer.
机构信息
From the *Department of Radiation Therapy and Oncology, Taichung Hospital, Department of Health, Executive Yuan; †Department of Radiation Oncology, China Medical University Hospital, Taichung; ‡Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, Taichung; §College of Medicine, Taipei Medical University, Taipei; ¶Department of Nuclear Medicine, E-Da Hospital/I-Shou University, Kaohsiung; and ∥Department of Surgery, China Medical University Hospital; **Department of Nuclear Medicine and PET Center, China Medical University Hospital; ††Department of Biomedical Imaging and Radiological Science, China Medical University; and ‡‡Department of Pathology, China Medical University Hospital, Taichung, Taiwan.
出版信息
Clin Nucl Med. 2014 Jan;39(1):e40-5. doi: 10.1097/RLU.0b013e318292f0f6.
PURPOSE
This study examined the correlations between F-FDG PET/CT results and tumor specimen pathology in patients with rectal cancer.
METHODS
Sixty-seven patients with rectal cancer who had received preoperative PET/CT were included in this study. Autosegmentation methods were used to determine the maximum PET/CT-based tumor length (TL), tumor width (TW), and metabolic tumor volume for each patient. The TL and TW values were compared with the maximum pathological length and width of the tumor specimen. To forecast the pathological T and N stages, a receiver operating characteristic curve was created for each parameter to evaluate its predictive ability. Logistic regression analysis was used to identify the predictors of pathology.
RESULTS
The values of 30% of maximum uptake for TL and 40% of maximum uptake for TW provided the best match with the maximum pathological tumor length and width (Pearson r = 0.72, P < 0.001; r = 0.44, P < 0.001, respectively). Metabolic tumor volume with a fixed threshold of 2.5 emerged as an independent factor for predicting the pathological T3 or T4 stage (P = 0.001; odds ratio, 1.81; 95% confidence interval, 1.26-2.60).
CONCLUSIONS
Preoperative PET/CT can be used as a supplemental tool in predicting pathological findings for patients with rectal cancer requiring operation.
目的
本研究旨在探讨直肠患者的 F-FDG PET/CT 结果与肿瘤标本病理学之间的相关性。
方法
本研究纳入了 67 例接受术前 PET/CT 的直肠患者。采用自动分割方法确定每位患者的最大基于 PET/CT 的肿瘤长度（TL）、肿瘤宽度（TW）和代谢肿瘤体积。将 TL 和 TW 值与肿瘤标本的最大病理长度和宽度进行比较。为了预测病理 T 和 N 分期，为每个参数绘制了接收者操作特征曲线以评估其预测能力。使用逻辑回归分析确定病理预测因素。
结果
TL 的最大摄取量的 30%和 TW 的最大摄取量的 40%的取值与最大病理肿瘤长度和宽度最佳匹配（Pearson r = 0.72，P < 0.001；r = 0.44，P < 0.001）。固定阈值为 2.5 的代谢肿瘤体积是预测病理 T3 或 T4 期的独立因素（P = 0.001；优势比，1.81；95%置信区间，1.26-2.60）。
结论
术前 PET/CT 可作为需要手术的直肠患者预测病理发现的辅助工具。
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