基于 18F-FDOPA PET 的 SUV 衍生指数与脑胶质瘤侵袭性的相关性：临床应用。

Correlation of SUV-Derived Indices With Tumoral Aggressiveness of Gliomas in Static 18F-FDOPA PET: Use in Clinical Practice.

机构信息

From the Departments of *Nuclear Medicine, †Neuro-oncology, and ‡Anatomopathology, CHU Nancy, Nancy; and §Department of Neuro-oncology, CHU Nancy, Poitiers, France.

出版信息

Clin Nucl Med. 2015 Sep;40(9):e429-35. doi: 10.1097/RLU.0000000000000897.

DOI:10.1097/RLU.0000000000000897

PMID:26204212

Abstract

PURPOSE

Glioma grading is necessary for prognostic evaluation and optimal treatment decisions. The aims of this study were to establish whether a correlation between F-FDOPA uptake with tumor grade was observed and to determine which of the SUV-derived indices was the best correlated.

PATIENTS AND METHODS

Thirty-one patients were retrospectively included (mean [SD] age, 36.8 [12.1] years) including 21 proven low-grade tumors due to histology, imaging, and clinical follow-up and 10 histologically proven high-grade tumors. Static PET acquisitions were postreconstructed between the 10th and 30th minute after injection of F-FDOPA. Regions of interest of 20 mm were applied to tumors, and isocontoured volumes were defined at levels of 50% and 80% of the peak intensity voxel. Background was quantified with 30-mm-diameter regions of interest on contralateral striatum and centrum semioval. Tumoral uptake was evaluated with the following SUV-derived indices: SUVmax, SUVmean, SUVmax, and SUVmean of isocontoured volume, tumor/striatum ratio (T/S), and tumor/normal brain ratio (T/N).

RESULTS

All the SUV-derived indices tested were significantly correlated with tumor grade, considering low-grade and high-grade groups (P < 0.05), except for the SUVmean 50%. The 2 best-correlated indices were SUVmean T/N and SUVmean T/S, with correlation coefficients of 0.561 and 0.522, respectively. Receiver operating characteristic analysis defined optimal thresholds of 1.33 and 1 for sensitivity and specificity of 71% and 100% and 67% and 100%, respectively.

CONCLUSIONS

F-FDOPA PET SUV-derived indices are routinely available information that enables accurate discrimination of low-grade and high-grade gliomas. The best-correlated indices were SUVmean T/N and SUVmean T/S with thresholds of 1.33 and 1.

摘要

目的

脑胶质瘤分级对于预后评估和最佳治疗决策至关重要。本研究旨在确定 F-FDOPA 摄取与肿瘤分级之间是否存在相关性，并确定哪种 SUV 衍生指标相关性最佳。

患者和方法

回顾性纳入 31 例患者（平均[标准差]年龄 36.8[12.1]岁），包括 21 例经组织学、影像学和临床随访证实的低级别肿瘤，10 例经组织学证实的高级别肿瘤。注射 F-FDOPA 后 10 至 30 分钟进行静态 PET 采集。在肿瘤上应用 20mm 感兴趣区（ROI），并在峰值强度像素的 50%和 80%水平定义等浓度体积 ROI。用直径 30mm 的 ROI 在对侧纹状体和半卵圆中心定量背景。通过以下 SUV 衍生指标评估肿瘤摄取：SUVmax、SUVmean、等浓度体积的 SUVmax 和 SUVmean、肿瘤/纹状体比值（T/S）和肿瘤/正常脑比值（T/N）。

结果

所有测试的 SUV 衍生指标与肿瘤分级均显著相关（P < 0.05），除 SUVmean50%外，还考虑了低级别和高级别组。相关性最好的两个指标是 SUVmeanT/N 和 SUVmeanT/S，相关系数分别为 0.561 和 0.522。受试者工作特征分析定义了最佳阈值为 1.33 和 1，敏感性和特异性分别为 71%和 100%，67%和 100%。