Goense Lucas, Heethuis Sophie E, van Rossum Peter S N, Voncken Francine E M, Lagendijk Jan J W, Lam Marnix G E H, Terhaard Chris H, van Hillegersberg Richard, Ruurda Jelle P, Mook Stella, van Lier Astrid L H M W, Lin Steven H, Meijer Gert J
Departments of Radiation Oncology.
Surgery, University Medical Center Utrecht, Utrecht.
Nucl Med Commun. 2018 Jan;39(1):60-67. doi: 10.1097/MNM.0000000000000771.
Both the apparent diffusion coefficient (ADC) acquired by diffusion-weighted magnetic resonance imaging (DW-MRI) and the standardized uptake value (SUV), acquired by F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT), are well-established functional parameters in cancer imaging. Currently, it is unclear whether these two markers provide complementary prognostic and predictive information in esophageal cancer. The aim of this study was to evaluate the correlation between ADC and SUV in patients with esophageal cancer.
This prospective study included 76 patients with histologically proven esophageal cancer who underwent both DW-MRI and F-FDG PET/CT examinations before treatment. The minimum and mean ADC values (ADCmin and ADCmean) of the primary tumor were assessed on MRI. Similarly, the glucose metabolism was evaluated by the maximum and mean SUV (SUVmax and SUVmean) in the same lesions on F-FDG PET/CT images. Spearman's rank correlation coefficients were used to assess the correlation between tumor ADC and SUV values.
The tumor ADC and SUV values as measures of cell density and glucose metabolism, respectively, showed negligible nonsignificant correlations (ADCmin vs. SUVmax: r=-0.087, P=0.457; ADCmin vs. SUVmean: r=-0.105, P=0.369; ADCmean vs. SUVmax: r=-0.099, P=0.349; ADCmean vs. SUVmean: r=-0.111, P=0.340). No differences in tumor ADC and SUV values were observed between the different histologic tumor types, stages, and differentiation grades.
This study indicates that tumor cellularity derived from DW-MRI and tumor metabolism measured by F-FDG PET/CT are independent cellular phenomena in newly diagnosed esophageal cancer. Therefore, tumor ADC and SUV values may play complementary roles as imaging markers in the prediction of survival and evaluation of response to treatment in esophageal cancer.
通过扩散加权磁共振成像（DW-MRI）获得的表观扩散系数（ADC）和通过F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）获得的标准化摄取值（SUV），都是癌症成像中成熟的功能参数。目前，尚不清楚这两个标志物在食管癌中是否能提供互补的预后和预测信息。本研究的目的是评估食管癌患者ADC与SUV之间的相关性。
这项前瞻性研究纳入了76例经组织学证实为食管癌的患者，这些患者在治疗前均接受了DW-MRI和F-FDG PET/CT检查。在MRI上评估原发肿瘤的最小和平均ADC值（ADCmin和ADCmean）。同样，通过F-FDG PET/CT图像上相同病变的最大和平均SUV（SUVmax和SUVmean）来评估葡萄糖代谢。采用Spearman等级相关系数评估肿瘤ADC与SUV值之间的相关性。
肿瘤ADC值和SUV值分别作为细胞密度和葡萄糖代谢的指标，显示出可忽略不计的非显著相关性（ADCmin与SUVmax：r=-0.087，P=0.457；ADCmin与SUVmean：r=-0.105，P=0.369；ADCmean与SUVmax：r=-0.099，P=0.349；ADCmean与SUVmean：r=-0.111，P=0.340）。在不同组织学肿瘤类型、分期和分化程度之间，未观察到肿瘤ADC值和SUV值的差异。
本研究表明，DW-MRI得出的肿瘤细胞密度和F-FDG PET/CT测量的肿瘤代谢是新诊断食管癌中独立的细胞现象。因此，肿瘤ADC值和SUV值在预测食管癌生存及评估治疗反应方面，可能作为成像标志物发挥互补作用。
