Moon Seung Hwan, Cho Young Seok, Son Young-Ik, Ahn Yong Chan, Ahn Myung-Ju, Choi Joon Young, Kim Byung-Tae, Lee Kyung-Han
1 Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
2 Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Br J Radiol. 2016 Nov;89(1067):20160109. doi: 10.1259/bjr.20160109. Epub 2016 Sep 21.
This study investigated the value of fluorine-18 fludeoxyglucose (F-FDG) heterogeneity as an indicator of metastatic lymph nodes (LNs) in patients with nasopharyngeal carcinoma (NPC). We further assessed whether addition of this parameter improves diagnostic performance beyond that provided by maximum standardized uptake value (SUV).
We analyzed 74 LNs that were suspicious for metastasis. These LNs were measured for coefficient of variation (CV) of F-FDG uptake, which was used as a parameter for F-FDG heterogeneity.
Multivariate logistic regression analyses revealed that a high CV (hazard ratio, 20.97; 95% confidence interval, 2.26-194.62; p = 0.007) was an independent predictor of metastatic LNs. However, receiver-operating characteristic curve analysis (p = 0.278) and net reclassification (p = 0.539) were unable to show improved diagnostic performance by addition of CV to SUV.
High CV of F-FDG uptake is an independent risk factor for metastatic LNs in patients with NPC displaying suspicious LNs following treatment. Advances in knowledge: Heterogeneity of F-FDG uptake has a potential as a biomarker of metastatic LNs.
本研究调查了氟-18氟脱氧葡萄糖（F-FDG）异质性作为鼻咽癌（NPC）患者转移性淋巴结（LNs）指标的价值。我们进一步评估了添加该参数是否能在最大标准化摄取值（SUV）之外提高诊断性能。
我们分析了74个可疑转移的淋巴结。测量这些淋巴结的F-FDG摄取变异系数（CV），将其用作F-FDG异质性的参数。
多因素逻辑回归分析显示，高CV（风险比，20.97；95%置信区间，2.26-194.62；p = 0.007）是转移性淋巴结的独立预测因素。然而，受试者工作特征曲线分析（p = 0.278）和净重新分类（p = 0.539）未能显示添加CV到SUV后诊断性能有所改善。
F-FDG摄取的高CV是治疗后显示可疑淋巴结的NPC患者转移性淋巴结的独立危险因素。知识进展：F-FDG摄取的异质性有作为转移性淋巴结生物标志物的潜力。
