Kitajima Kazuhiro, Doi Hiroshi, Kuribayashi Kozo, Hashimoto Masaki, Tsuchitani Tatsuya, Tanooka Masao, Fukushima Kazuhito, Nakano Takashi, Hasegawa Seiki, Hirota Shozo
Division of Nuclear Medicine and PET Center, Department of Radiology, Hyogo College of Medicine, Hyogo, Japan.
Department of Radiology, Hyogo College of Medicine, Hyogo, Japan.
Eur J Radiol. 2017 Jan;86:176-183. doi: 10.1016/j.ejrad.2016.11.019. Epub 2016 Nov 15.
To investigate the relationships between pretreatment volume-based quantitative F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) parameters and overall survival (OS) in patients with malignant pleural mesothelioma (MPM).
We retrospectively reviewed data from 201 MPM patients, of whom 38 underwent surgical resection, and calculated the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), including primary tumors and nodal or distant metastatic lesions, on pretreatment F-FDG PET/CT. Relationships between clinicopathological factors (age, sex, performance status, European Organization for Research and Treatment of Cancer [EORTC] score, histological subtype, TNM stage, and treatment strategy), volume-based quantitative PET/CT parameters, and OS were evaluated using a Cox proportional hazards model and log-rank test.
The median follow-up was 15 months (range, 1-96 months; median, 17 months). In a univariate analysis of all patients, older age (p<0.05), high EORTC score (p<0.001), non-epithelioid histological subtype (p<0.001), high T stage (p<0.001), positive N/M status (p<0.05, p<0.001), advanced TNM stage (p<0.001), non-surgical treatment (p<0.001), and high SUVmax (p<0.001), MTV (p<0.001), or TLG (p<0.001) were associated with significantly shorter OS. A multivariate analysis confirmed non-epithelioid subtype (hazard ratio [HR]: 1.69, 95% confidence interval [CI]: 1.14-2.48; p<0.05), non-surgical treatment (HR: 0.58, 95% CI: 0.34-0.95; p<0.05), and high TLG (HR: 1.97, 95% CI: 1.14-3.44; p<0.05) as independent negative predictors.
Pretreatment volume-based quantitative F-FDG PET/CT parameters, especially TLG, could serve as potential surrogate markers for MPM prognosis.
探讨基于容积的治疗前氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）参数与恶性胸膜间皮瘤（MPM）患者总生存期（OS）之间的关系。
我们回顾性分析了201例MPM患者的数据，其中38例接受了手术切除，并在治疗前的F-FDG PET/CT上计算了最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总病灶糖酵解（TLG），包括原发性肿瘤以及淋巴结或远处转移病灶。使用Cox比例风险模型和对数秩检验评估临床病理因素（年龄、性别、体能状态、欧洲癌症研究与治疗组织[EORTC]评分、组织学亚型、TNM分期和治疗策略）、基于容积的定量PET/CT参数与OS之间的关系。
中位随访时间为15个月（范围1 - 96个月；中位数17个月）。在对所有患者的单因素分析中，年龄较大（p<0.05）、EORTC评分高（p<0.001）、非上皮样组织学亚型（p<0.001）、T分期高（p<0.001）、N/M状态为阳性（p<0.05，p<0.001）、TNM分期晚期（p<0.001）、非手术治疗（p<0.001）以及SUVmax高（p<0.001）、MTV高（p<0.001）或TLG高（p<0.001）均与OS显著缩短相关。多因素分析证实非上皮样亚型（风险比[HR]：1.69，95%置信区间[CI]：1.14 - 2.48；p<0.05）、非手术治疗（HR：0.58，95%CI：0.34 - 0.95；p<0.05）和高TLG（HR：1.97，95%CI：1.14 - 3.44；p<0.05）为独立的阴性预测指标。
基于容积的治疗前定量F-FDG PET/CT参数，尤其是TLG，可作为MPM预后的潜在替代标志物。
