Dubreuil Julien, Giammarile Francesco, Rousset Pascal, Rubello Domenico, Bakrin Naoual, Passot Guillaume, Isaac Sylvie, Glehen Olivier, Skanjeti Andrea
aNuclear Medicine Departement, Hospices Civils de Lyon, Lyon, France bEquipe Mixte de Recherche 3738, Université Claude Bernard Lyon 1, Lyon, France cLyon 1 University, 43 Boulevard du 11 Novembre 1918, 69100 Villeurbanne, France dRadiology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France eDepartment of Nuclear Medicine, and PET/CT Center, Santa Maria della Misericordia Hospital, Rovigo, Italy fGeneral and oncologic surgery Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France gPathology Department, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
Nucl Med Commun. 2017 Apr;38(4):312-318. doi: 10.1097/MNM.0000000000000649.
The aim of this study was to assess glucose metabolism of multicystic peritoneal mesothelioma and epithelioid peritoneal mesothelioma by fluorine-18 fluorodeoxyglucose (F-FDG)-PET/contrast-enhanced computed tomography (ceCT) and to assess its prognostic impact.
Twenty-three (14 women) patients, without previous treatment, underwent F-FDG-PET/ceCT before peritoneal mesothelioma cytoreductive surgery and intraperitoneal chemotherapy. F-FDG-PET/ceCT was interpreted prospectively as positive or negative. Maximum standardized uptake value (SUVmax) of each lesion was measured retrospectively on the basis of postsurgery data. At laparotomy, disease extension was estimated with the Peritoneal Cancer Index. The median follow-up was 27 months (95% confidence interval: 12.9-37.8); progression-free survival (PFS) was recorded.
Nine patients were affected by multicystic and 14 were affected by epithelioid peritoneal mesothelioma. PET showed mild focal uptake in one case of multicystic peritoneal mesothelioma, whereas in eight patients, no abnormal uptake was observed. PET was positive in 12/14 patients with epithelioid peritoneal mesothelioma. Sensitivity, specificity and accuracy were respectively 86, 89 and 87%; the qualitative assessment was statistically different (P=0.0020, χ). Multicystic peritoneal mesothelioma histology was significantly associated with lower SUVmaxlesion (P=0.0061), SUVmaxlesion/liver (P=0.0025), Peritoneal Cancer Index, younger age, and it was observed only in women.Recurrence was observed on nine patients affected by epithelioid peritoneal mesothelioma, whereas no recurrences were observed among multicystic peritoneal mesothelioma patients. SUVmaxlesion (P=0.0278) and age (P=0.0241) were significantly associated with PFS in patients with epithelioid peritoneal mesothelioma.
F-FDG-PET/ceCT showed significant differences between multicystic and epithelioid peritoneal mesothelioma, whereas SUVmaxlesion was associated with PFS in the latter. Although multicentre prospective studies are necessary, F-FDG-PET/ceCT appears to be a promising tool in patients affected by peritoneal mesothelioma.
本研究旨在通过氟-18氟脱氧葡萄糖（F-FDG）-PET/对比增强计算机断层扫描（ceCT）评估多囊性腹膜间皮瘤和上皮样腹膜间皮瘤的葡萄糖代谢，并评估其预后影响。
23例（14例女性）未经治疗的患者在腹膜间皮瘤细胞减灭术和腹腔内化疗前接受了F-FDG-PET/ceCT检查。F-FDG-PET/ceCT前瞻性地解读为阳性或阴性。根据术后数据回顾性测量每个病变的最大标准化摄取值（SUVmax）。在剖腹手术中，用腹膜癌指数评估疾病范围。中位随访时间为27个月（95%置信区间：12.9 - 37.8）；记录无进展生存期（PFS）。
9例患者患有多囊性腹膜间皮瘤，14例患者患有上皮样腹膜间皮瘤。PET在1例多囊性腹膜间皮瘤患者中显示轻度局灶性摄取，而在8例患者中未观察到异常摄取。14例上皮样腹膜间皮瘤患者中有12例PET呈阳性。敏感性、特异性和准确性分别为86%、89%和87%；定性评估在统计学上有差异（P = 0.0020，χ检验）。多囊性腹膜间皮瘤组织学与较低的SUVmax病变（P = 0.0061）、SUVmax病变/肝脏（P = 0.0025）、腹膜癌指数、较年轻的年龄显著相关，且仅在女性中观察到。9例上皮样腹膜间皮瘤患者出现复发，而多囊性腹膜间皮瘤患者未观察到复发。SUVmax病变（P = 0.0278）和年龄（P = 0.0241）与上皮样腹膜间皮瘤患者的PFS显著相关。
F-FDG-PET/ceCT显示多囊性和上皮样腹膜间皮瘤之间存在显著差异，而SUVmax病变与后者的PFS相关。尽管需要多中心前瞻性研究，但F-FDG-PET/ceCT似乎是腹膜间皮瘤患者的一种有前景的工具。
