LoGiurato Brendan, Matthews Robert, Safaie Elham, Moore William, Bilfinger Thomas, Relan Nand, Franceschi Dinko
Departments of aRadiology bSurgery, Division of Thoracic Surgery, Stony Brook University School of Medicine, New York, New York, USA.
Nucl Med Commun. 2015 Sep;36(9):908-13. doi: 10.1097/MNM.0000000000000344.
The aim of this study was to understand the imaging features of fluorine-18 fluorodeoxyglucose ((18)F-FDG) PET-computed tomography (CT) in postcryoablation lung cancer patients that could help predict recurrence.
We identified 28 patients with 30 lesions treated by means of percutaneous cryoablation for stage I non-small-cell lung cancer. Two experienced nuclear radiologists blindly reviewed baseline images and follow-up (18)F-FDG PET-CT scans for a minimum of 24 months, with discrepancy in interpretation resolved by consensus. Nineteen lesions had undergone baseline PET-CT studies, whereas 11 lesions had undergone only baseline CT studies. Follow-up PET-CT studies were analyzed for up to 24 months, whereas the recurrence-free survival analysis was performed for 36 months.
The average maximum standardized uptake value (SUV(max)) at baseline (n = 19) was 5.2 ± 3.9 and the average CT area at baseline was 2.2 ± 1.6 cm(2). Only the CT area was significantly different between recurring and nonrecurring lesions at baseline (P = 0.0028). The Kaplan-Meier survival analysis showed that dichotomizing lesions around 2 cm on CT did not result in a statistically significant survival difference (hazard ratio = 1.42, 95% confidence interval: 0.63-2.21). The average SUV(max) at first follow-up was 1.9 ± 1.8 for 27 lesions, whereas the average SUV(max) of recurrent lesions was 2.2 ± 2.2 and that of nonrecurrent lesions was 1.5 ± 0.3 (P = 0.17). Six lesions had SUV(max) more than or equal to 2.5 within 24 months, all of which recurred in the ablation zone.
(18)F-FDG PET-CT is a valuable tool for determining treatment response and for distinguishing benign from malignant lesions after cryoablation. The CT area was most predictive of future recurrence at baseline, whereas SUV(max) more than or equal to 2.5 was most predictive of future recurrence at first follow-up.
本研究旨在了解氟-18氟脱氧葡萄糖((18)F-FDG)正电子发射断层扫描-计算机断层扫描(PET-CT)在冷冻消融术后肺癌患者中的成像特征,以帮助预测复发情况。
我们纳入了28例患有30个病灶的患者,这些患者因I期非小细胞肺癌接受了经皮冷冻消融治疗。两位经验丰富的核放射科医生对基线图像和至少24个月的随访(18)F-FDG PET-CT扫描进行了盲法评估,解释上的差异通过共识解决。19个病灶进行了基线PET-CT研究,而11个病灶仅进行了基线CT研究。对随访PET-CT研究进行了长达24个月的分析,而无复发生存分析进行了36个月。
基线时(n = 19)的平均最大标准化摄取值(SUV(max))为5.2±3.9,基线时的平均CT面积为2.2±1.6 cm²。仅基线时复发和未复发病灶之间的CT面积有显著差异(P = 0.0028)。Kaplan-Meier生存分析表明,将CT上约2 cm周围的病灶进行二分法划分并未导致统计学上显著的生存差异(风险比= 1.42,95%置信区间:0.63 - 2.21)。27个病灶首次随访时的平均SUV(max)为1.9±1.8,而复发病灶的平均SUV(max)为2.2±2.2,未复发病灶的平均SUV(max)为1.5±0.3(P = 0.17)。6个病灶在24个月内SUV(max)大于或等于2.5,所有这些病灶均在消融区内复发。
(18)F-FDG PET-CT是确定治疗反应以及区分冷冻消融术后良性与恶性病灶的有价值工具。基线时CT面积对未来复发的预测性最强,而首次随访时SUV(max)大于或等于2.5对未来复发的预测性最强。