Wang Zu-Fei, Fan Xiao-Xi, Xu Min, Chen Min-Jiang, Zhao Zhong-Wei, Zhou Jun-Dong, Tu Jian-Fei, Song Jing-Jing, Hu Xiang-Hua, Lu Chen-Ying, Wu Fa-Zong, Zhang Deng-Ke, Chen Li, Liu Lu, Ying Xi-Hui, Xu Xiao-Fei, Ji Jian-Song
1 Radiology Department and Interventional Radiology Center, The Fifth Affiliated Hospital of Wenzhou Medical University, Affiliated Lishui Hospital of Zhejiang University, The Central Hospital of Zhejiang Lishui, Lishui, P.R. China.
2 Department of Radiotherapy, Affiliated Suzhou Municipal Hospital of Nanjing Medical University, Suzhou, P.R. China.
Tumour Biol. 2017 May;39(5):1010428317701656. doi: 10.1177/1010428317701656.
Our study aims to evaluate the efficacy of transcatheter arterial chemoembolization in the treatment of patients with liver metastasis using integrated F-fluorodeoxyglucose positron emission tomography/computed tomography. A total of 97 liver metastasis patients treated by transcatheter arterial chemoembolization were enrolled in this study. The F-fluorodeoxyglucose positron emission tomography/computed tomography images of liver metastasis patients were collected before and after transcatheter arterial chemoembolization treatment. The efficacy of transcatheter arterial chemoembolization for the treatment of liver metastasis was evaluated according to the revised Response Evaluation Criteria in Solid Tumors guidelines. The receiver operating characteristic curve analysis was used to determine cut-off values of F-fluorodeoxyglucose positron emission tomography parameters (Tsuvmax, Tsuvmax/Lsuvmax, and Tsuvmax/Lsuvmean) for predicting the efficacy of transcatheter arterial chemoembolization. Progression-free survival and the incidence of postoperative complications were compared. Correlation of Tsuvmax, Tsuvmax/Lsuvmax, and Tsuvmax/Lsuvmean with blood supply and lipiodol deposition in the lesion was analyzed. Among three F-fluorodeoxyglucose positron emission tomography parameters, the receiver operating characteristic analysis showed that Tsuvmax/Lsuvmax with a cut-off value of 3.56 was the best predictor of transcatheter arterial chemoembolization efficacy. According to the cut-off value of Tsuvmax/Lsuvmax, liver metastasis patients were divided into the Tsuvmax/Lsuvmax ≤ 3.56 and Tsuvmax/Lsuvmax > 3.56 groups. Compared with the Tsuvmax/Lsuvmax > 3.56 group, the Tsuvmax/Lsuvmax ≤ 3.56 group showed a longer progression-free survival and a lower incidence of postoperative complications. The Tsuvmax, Tsuvmax/Lsuvmax, and Tsuvmax/Lsuvmean in the lesion with abundant blood supply were significantly lower than those in peripheral liver parenchyma, while the Tsuvmax, Tsuvmax/Lsuvmax, and Tsuvmax/Lsuvmean in the lesion with lack of blood supply were significantly higher than those in peripheral liver parenchyma. Spearman correlation analysis indicated that lipiodol deposition in the lesion was positively correlated with the Tsuvmax, Tsuvmax/Lsuvmax, and Tsuvmax/Lsuvmean. The Tsuvmax/Lsuvmax of F-fluorodeoxyglucose positron emission tomography/computed tomography may be a good tool for predicting the blood supply and efficacy of transcatheter arterial chemoembolization for patients with liver metastasis.
我们的研究旨在使用集成的F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描评估经导管动脉化疗栓塞术治疗肝转移患者的疗效。本研究共纳入97例接受经导管动脉化疗栓塞术治疗的肝转移患者。收集肝转移患者在经导管动脉化疗栓塞术治疗前后的F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描图像。根据修订后的实体瘤疗效评价标准指南评估经导管动脉化疗栓塞术治疗肝转移的疗效。采用受试者工作特征曲线分析来确定F-氟脱氧葡萄糖正电子发射断层扫描参数（Tsuvmax、Tsuvmax/Lsuvmax和Tsuvmax/Lsuvmean）的临界值，以预测经导管动脉化疗栓塞术的疗效。比较无进展生存期和术后并发症的发生率。分析Tsuvmax、Tsuvmax/Lsuvmax和Tsuvmax/Lsuvmean与病变血供和碘油沉积的相关性。在三个F-氟脱氧葡萄糖正电子发射断层扫描参数中，受试者工作特征分析表明，临界值为3.56的Tsuvmax/Lsuvmax是经导管动脉化疗栓塞术疗效的最佳预测指标。根据Tsuvmax/Lsuvmax的临界值，将肝转移患者分为Tsuvmax/Lsuvmax≤3.56组和Tsuvmax/Lsuvmax＞3.56组。与Tsuvmax/Lsuvmax＞3.56组相比，Tsuvmax/Lsuvmax≤3.56组的无进展生存期更长，术后并发症发生率更低。血供丰富的病变中的Tsuvmax、Tsuvmax/Lsuvmax和Tsuvmax/Lsuvmean显著低于肝外周实质中的相应参数，而血供缺乏的病变中的Tsuvmax、Tsuvmax/Lsuvmax和Tsuvmax/Lsuvmean显著高于肝外周实质中的相应参数。Spearman相关性分析表明，病变中的碘油沉积与Tsuvmax、Tsuvmax/Lsuvmax和Tsuvmax/Lsuvmean呈正相关。F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描的Tsuvmax/Lsuvmax可能是预测肝转移患者经导管动脉化疗栓塞术血供和疗效的良好工具。
