Sürer Budak Evrim, Toptaş Tayfun, Aydın Funda, Öner Ali Ozan, Çevikol Can, Şimşek Tayup
Akdeniz University Faculty of Medicine, Department of Nuclear Medicine, Antalya, Turkey Phone: +90 532 638 06 54 E-mail:
Mol Imaging Radionucl Ther. 2017 Feb 5;26(1):24-32. doi: 10.4274/mirt.30306.
To explore the correlation of the primary tumor's maximum standardized uptake value (SUV) and minimum apparent diffusion coefficient (ADC) with clinicopathologic features, and to determine their predictive power in endometrial cancer (EC).
A total of 45 patients who had undergone staging surgery after a preoperative evaluation with F-fluorodeoxyglucose (FDG) positron emission tomography/computerized tomography (PET/CT) and diffusion-weighted magnetic resonance imaging (DW-MRI) were included in a prospective case-series study with planned data collection. Multiple linear regression analysis was used to determine the correlations between the study variables.
The mean ADC and SUV values were determined as 0.72±0.22 and 16.54±8.73, respectively. A univariate analysis identified age, myometrial invasion (MI) and lymphovascular space involvement (LVSI) as the potential factors associated with ADC while it identified age, stage, tumor size, MI, LVSI and number of metastatic lymph nodes as the potential variables correlated to SUV. In multivariate analysis, on the other hand, MI was the only significant variable that correlated with ADC (p=0.007) and SUV (p=0.024). Deep MI was best predicted by an ADC cutoff value of ≤0.77 [93.7% sensitivity, 48.2% specificity, and 93.0% negative predictive value (NPV)] and SUV cutoff value of >20.5 (62.5% sensitivity, 86.2% specificity, and 81.0% NPV); however, the two diagnostic tests were not significantly different (p=0.266).
Among clinicopathologic features, only MI was independently correlated with SUV and ADC. However, the routine use of F-FDG PET/CT or DW-MRI cannot be recommended at the moment due to less than ideal predictive performances of both parameters.
探讨原发性肿瘤的最大标准化摄取值（SUV）和最小表观扩散系数（ADC）与临床病理特征的相关性，并确定它们对子宫内膜癌（EC）的预测能力。
共有45例患者在术前行F-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）和扩散加权磁共振成像（DW-MRI）评估后接受了分期手术，纳入一项计划收集数据的前瞻性病例系列研究。采用多元线性回归分析来确定研究变量之间的相关性。
平均ADC值和SUV值分别确定为0.72±0.22和16.54±8.73。单因素分析确定年龄、肌层浸润（MI）和脉管间隙浸润（LVSI）为与ADC相关的潜在因素，而年龄、分期、肿瘤大小、MI、LVSI和转移淋巴结数量为与SUV相关的潜在变量。另一方面，在多因素分析中，MI是与ADC（p=0.007）和SUV（p=0.024）相关的唯一显著变量。深度MI的最佳预测值为ADC截止值≤0.77 [灵敏度93.7%，特异性48.2%，阴性预测值（NPV）93.0%]和SUV截止值>20.5（灵敏度62.5%，特异性86.2%，NPV 81.0%）；然而，这两种诊断测试无显著差异（p=0.266）。
在临床病理特征中，只有MI与SUV和ADC独立相关。然而，由于这两个参数的预测性能均不理想，目前不建议常规使用F-FDG PET/CT或DW-MRI。
