利用（18）F-FDG PET/CT参数测定食管癌患者区域淋巴结状态：SUV、体积参数及肿瘤内异质性的比较
Determination of regional lymph node status using (18)F-FDG PET/CT parameters in oesophageal cancer patients: comparison of SUV, volumetric parameters and intratumoral heterogeneity.
作者信息
Kim Seong-Jang, Pak Kyoungjune, Chang Samuel
机构信息
1 Department of Nuclear Medicine, Pusan National University Hospital, Busan, Korea.
2 Medical Research Institute, Pusan National University, Busan, Korea.
出版信息
Br J Radiol. 2016;89(1058):20150673. doi: 10.1259/bjr.20150673. Epub 2015 Nov 26.
OBJECTIVE
We aimed to investigate whether the standardized uptake values, volumetric parameters and intratumoral heterogeneity of fluorine-18-fludeoxyglucose ((18)F-FDG) uptake could predict regional lymph node (rLN) metastasis in oesophageal cancer.
METHODS
51 patients with surgically resected oesophageal cancer were included in the present study. The (18)F-FDG positron emission tomography (PET)/CT findings and rLN metastasis were compared with the histopathological results. The intratumoral metabolic heterogeneity was represented by the heterogeneity factor (HF), which was determined for each patient. Univariate and multivariate analyses were used to analyse the associations between the rLN metastasis and clinical findings, standardized uptake values, metabolic tumour volume (MTV), total lesion glycolysis (TLG) and HF.
RESULTS
The rLN(+) group showed statistically significant higher values of MTV (median, 13.59 vs 6.6; p = 0.0085), TLG (median, 119.18 vs 35.96; p = 0.0072) and HF (median, 3.07 vs 2.384; p = 0.0002) than the rLN(-) group. Univariate analysis showed that maximum standardized uptake value, mean standardized uptake value, MTV, TLG and HF were significantly associated with pathologic rLN involvement. However, in multivariate analysis, the HF was a potent associated factor for the prediction of pathologic rLN metastasis in oesophageal cancer.
CONCLUSION
In conclusion, (18)F-FDG PET/CT parameters such as maximum standardized uptake value, mean standardized uptake value, MTV, TLG and HF were useful for the prediction of pathologic rLN status in patients with oesophageal cancer. However, HF might be the most powerful predictor of rLN metastasis of patients with oesophageal cancer.
ADVANCES IN KNOWLEDGE
Assessment of intratumoral heterogeneity of (18)F-FDG PET/CT may be a useful adjunct for rLN staging of oesophageal cancer.
目的
我们旨在研究氟-18-氟脱氧葡萄糖（¹⁸F-FDG）摄取的标准化摄取值、体积参数及瘤内异质性是否能够预测食管癌区域淋巴结（rLN）转移。
方法
本研究纳入51例接受手术切除的食管癌患者。将¹⁸F-FDG正电子发射断层扫描（PET）/CT检查结果及rLN转移情况与组织病理学结果进行比较。瘤内代谢异质性用异质性因子（HF）表示，针对每位患者进行测定。采用单因素和多因素分析来分析rLN转移与临床特征、标准化摄取值、代谢肿瘤体积（MTV）、总病灶糖酵解（TLG）及HF之间的关联。
结果
rLN（+）组的MTV（中位数，13.59对6.6；p = 0.0085）、TLG（中位数，119.18对35.96；p = 0.0072）及HF（中位数，3.07对2.384；p = 0.0002）在统计学上显著高于rLN（-）组。单因素分析显示，最大标准化摄取值、平均标准化摄取值、MTV、TLG及HF与病理rLN受累显著相关。然而，多因素分析中，HF是预测食管癌病理rLN转移的有效相关因素。
结论
总之，¹⁸F-FDG PET/CT参数如最大标准化摄取值、平均标准化摄取值、MTV、TLG及HF对预测食管癌患者的病理rLN状态有用。然而，HF可能是食管癌患者rLN转移的最有力预测指标。
知识进展
评估¹⁸F-FDG PET/CT的瘤内异质性可能是食管癌rLN分期的有用辅助手段。
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