非小细胞肺癌的多功能评估：灌注-代谢相关性。
Multifunctional Assessment of Non-Small Cell Lung Cancer: Perfusion-Metabolic Correlation.
出版信息
Clin Nucl Med. 2018 Jan;43(1):e18-e24. doi: 10.1097/RLU.0000000000001888.
PURPOSE
The aim of this study was to investigate the relationship between whole-tumor CT perfusion and FDG PET/CT parameters in non-small cell lung cancer (NSCLC).
METHODS
Twenty-five patients with NSCLC were prospectively included. CT perfusion parameters calculated were blood flow (BF), blood volume (BV), mean transit time, and peak enhancement intensity. SUVmax, SUVpeak, SUVmean, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were evaluated for PET/CT. Tumor diameter and volume were measured, and lesions were divided according to maximum axial diameter in more than 3 cm and 3 cm or less. The correlations between CT perfusion and PET/CT parameters were assessed in all tumors, as well as according to tumor diameter and volume.
RESULTS
Lesion diameter and volume showed a negative correlation with BF and BV (r = -0.78, -0.78, -0.57, -0.48, respectively) and a positive correlation with mean transit time (r = 0.55, 0.65, respectively). The negative correlation between BF and lesion diameter and volume was confirmed in the subgroup of lesions of more than 3 cm (r = -0.68, -0.68, respectively). A positive correlation between SUVmax, SUVpeak, SUVmean, and lesion volume was observed (r = 0.50, 0.50, 0.46, respectively) and confirmed in lesions 3 cm or less (r = 0.81, 0.79, 0.78, respectively). Metabolic tumor volume and TLG showed a positive correlation with lesion diameter and volume in the overall population (r = 0.93, 0.87, 0.88, 0.90, respectively) and in lesions of more than 3 cm (r = 0.89, 0.84, 0.84, 0.79, respectively). Blood flow and BV showed a negative correlation with MTV and TLG (r = -0.77, -0.74, and -0.58, -0.48, respectively) in the overall population and with MTV in lesions of more than 3 cm (r = -0.69, -0.62, respectively).
CONCLUSIONS
Perfusion and metabolic parameters seem to depend on tumor size. The bigger the tumor, the lower the BF and the BV and, conversely, the higher the SUVpeak, MTV, and TLG. This information would be useful in the clinical setting when diagnosing or treating NSCLC, especially with novel therapies and/or for radiation treatment modulation.
目的
本研究旨在探讨非小细胞肺癌（NSCLC）中全肿瘤 CT 灌注与 FDG PET/CT 参数之间的关系。
方法
前瞻性纳入 25 例 NSCLC 患者。计算 CT 灌注参数包括血流量（BF）、血容量（BV）、平均通过时间和峰值强化强度。评估 PET/CT 的最大标准摄取值（SUVmax）、最大标准摄取值峰值（SUVpeak）、SUV 均值（SUVmean）、代谢肿瘤体积（MTV）和总肿瘤糖酵解（TLG）。测量肿瘤直径和体积，并根据最大轴向直径大于 3cm 和等于或小于 3cm 对病灶进行划分。评估所有肿瘤、根据肿瘤直径和体积的 CT 灌注与 PET/CT 参数之间的相关性。
结果
病灶直径和体积与 BF 和 BV 呈负相关（r=-0.78，-0.78，-0.57，-0.48），与平均通过时间呈正相关（r=0.55，0.65）。BF 与病灶直径和体积的负相关在直径大于 3cm 的亚组中得到证实（r=-0.68，-0.68）。SUVmax、SUVpeak、SUVmean 与病灶体积呈正相关（r=0.50，0.50，0.46），并在直径等于或小于 3cm 的病灶中得到证实（r=0.81，0.79，0.78）。代谢肿瘤体积和 TLG 与总体人群中的病灶直径和体积呈正相关（r=0.93，0.87，0.88，0.90），在直径大于 3cm 的病灶中呈正相关（r=0.89，0.84，0.84，0.79）。BF 和 BV 与 MTV 和 TLG 在总体人群中呈负相关（r=-0.77，-0.74，-0.58，-0.48），与直径大于 3cm 的病灶中的 MTV 呈负相关（r=-0.69，-0.62）。
结论
灌注和代谢参数似乎取决于肿瘤大小。肿瘤越大，BF 和 BV 越低，而 SUVpeak、MTV 和 TLG 越高。在诊断或治疗 NSCLC 时，特别是在使用新的治疗方法和/或进行放射治疗调制时，这些信息将非常有用。
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