Demir Yusuf, Sürücü Erdem, Şengöz Tarik, Koç Murat, Kaya Gamze Ç
aDepartment of Nuclear Medicine, School of Medicine, Yüzüncü Yil University, Van bDepartment of Nuclear Medicine, School of Medicine, Pamukkale University, Denizli cDepartment of Nuclear Medicine, Atatürk Government Hospital, Aydin dDepartment of Nuclear Medicine, School of Medicine, Dokuz Eylül University, İzmir, Turkey.
Nucl Med Commun. 2016 Feb;37(2):116-21. doi: 10.1097/MNM.0000000000000412.
The aim of this study was to evaluate, using PET/computed tomography (CT), changes in liver metabolic activity in patients with locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (CRT).
A total of 29 biopsy-proven LARC patients between 2009 and 2012 were studied. Liver standardized uptake values (SUVs) and SUVs adjusted for lean body mass (SULs) were obtained from PET/CT images obtained at 1 h (early) and 2 h (late) after (18)F-fluorodeoxyglucose ((18)F-FDG) administration both before and after neoadjuvant CRT. Age, sex, BMI, lean body mass, blood glucose level, and (18)F-FDG dose, which can influence liver SUVs and SULs, were also analyzed.
Fourteen (48%) men and 15 (52%) women with a mean age of 62±11 years (range 34-80 years) were included in the study. The mean SUVs and SULs were significantly decreased in the late scans. Sex was significantly correlated with the mean liver SUV in early and late scans. The mean SUV differed significantly between male and female patients in early and late images (P<0.05). In a multivariate stepwise regression analysis, only liver SUVs (maximum and mean) were significantly associated with BMI before and after therapy. SUVs were significantly higher in the high (≥25) BMI group after but not before therapy. Mean SUL was not influenced by BMI.
Liver (18)F-FDG uptake is consistent before and after neoadjuvant CRT therapy in patients with LARC. When assessing response to therapy and using liver metabolic activity to indicate background activity, BMI should be considered as it can influence liver metabolic activity.
本研究旨在利用正电子发射断层扫描/计算机断层扫描（PET/CT）评估局部晚期直肠癌（LARC）患者在新辅助放化疗（CRT）后肝脏代谢活性的变化。
对2009年至2012年间29例经活检证实的LARC患者进行了研究。在新辅助CRT前后，分别于注射（18）F-氟脱氧葡萄糖（（18）F-FDG）后1小时（早期）和2小时（晚期）获取PET/CT图像，测量肝脏标准化摄取值（SUVs）以及根据瘦体重调整后的SUVs（SULs）。同时分析了年龄、性别、体重指数（BMI）、瘦体重、血糖水平以及（18）F-FDG剂量，这些因素可能会影响肝脏的SUVs和SULs。
本研究纳入了14例（48%）男性和15例（52%）女性，平均年龄为62±11岁（范围34 - 80岁）。晚期扫描时，平均SUVs和SULs显著降低。性别与早期和晚期扫描时的平均肝脏SUV显著相关。在早期和晚期图像中，男性和女性患者的平均SUV存在显著差异（P<0.05）。在多因素逐步回归分析中，仅肝脏SUVs（最大值和平均值）在治疗前后均与BMI显著相关。治疗后高BMI（≥25）组的SUVs显著高于治疗前，但平均SUL不受BMI影响。
LARC患者在新辅助CRT治疗前后肝脏（18）F-FDG摄取是一致的。在评估治疗反应并利用肝脏代谢活性来指示背景活性时，应考虑BMI，因为它会影响肝脏代谢活性。
