Yonezawa Natsuki, Minamikawa Tsutomu, Kitajima Kazuhiro, Takahashi Yusuke, Sasaki Ryohei, Nibu Ken-Ichi, Komori Takahide
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Radiology, Division of Nuclear Medicine and PET Center, Hyogo College of Medicine, Japan.
Nagoya J Med Sci. 2017 Feb;79(2):189-198. doi: 10.18999/nagjms.79.2.189.
The aim of this study was to investigate the prognostic value of dual-time-point (DTP) F-fluorodeoxyglucose positron emission tomography (F-FDG PET) imaging in primary oral tongue squamous cell carcinoma (OTSCC). The study included 52 patients who underwent preoperative F-FDG PET scans at two time points, namely 1 h and 2 h after injection. The following PET parameters were calculated: maximum standardized uptake value (SUVmax) for both time points (SUV early, SUV delayed); retention index (RI); and SUVmax increment (ΔSUVmax). Receiver operating characteristic (ROC) curve analysis was performed to define the optimal cutoff point for these parameters. Overall survival was calculated using the Kaplan-Meier method. Prognostic factors for patients with OTSCC were evaluated using the univariate log-rank test and a multivariate Cox proportional hazards model. ROC analysis revealed that the area under the curve was higher and more accurate for ΔSUVmax than for the other parameters. Additionally, patients with a ΔSUVmax ≥0.9 had significantly worse survival outcomes (28.9% vs 92.6%; < 0.01). Univariate analysis showed that prognosis was significantly correlated with clinical T stage, local recurrence, perineural invasion, vascular invasion, and PET parameters ( < 0.05 for all). Multivariate analysis showed that local recurrence (hazard ratio = 3.60; = 0.02) and ΔSUVmax (hazard ratio = 8.43; < 0.01) were independent prognostic factors. ΔSUVmax determined using DTP F-FDG PET may be an additional prognostic factor in OTSCC patients.
本研究旨在探讨双时间点(DTP)氟脱氧葡萄糖正电子发射断层扫描(F-FDG PET)成像在原发性口腔舌鳞状细胞癌(OTSCC)中的预后价值。该研究纳入了52例在两个时间点(即注射后1小时和2小时)接受术前F-FDG PET扫描的患者。计算了以下PET参数:两个时间点的最大标准化摄取值(SUVmax)(早期SUV,延迟SUV);滞留指数(RI);以及SUVmax增量(ΔSUVmax)。进行了受试者操作特征(ROC)曲线分析以确定这些参数的最佳截断点。采用Kaplan-Meier方法计算总生存期。使用单变量对数秩检验和多变量Cox比例风险模型评估OTSCC患者的预后因素。ROC分析显示,ΔSUVmax的曲线下面积高于其他参数且更准确。此外,ΔSUVmax≥0.9的患者生存结局明显更差(28.9%对92.6%;P<0.01)。单变量分析显示,预后与临床T分期、局部复发、神经周围侵犯、血管侵犯和PET参数显著相关(均P<0.05)。多变量分析显示,局部复发(风险比=3.60;P=0.02)和ΔSUVmax(风险比=8.43;P<0.01)是独立的预后因素。使用DTP F-FDG PET测定的ΔSUVmax可能是OTSCC患者的一个额外预后因素。