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3个月的F-18氟代脱氧葡萄糖正电子发射断层显像/X线计算机体层成像(F-18 FDG PET/CT)监测在手术切除的口腔鳞状细胞癌中的应用价值

Utility of 3-Month Surveillance F-18 FDG PET/CT in Surgically Resected Oral Squamous Cell Carcinoma.

作者信息

Marquardt Michael, Anderson Carryn, Ginader Timothy, Parkhurst Jessica, Pagedar Nitin, Bayon Rodrigo, Clamon Gerald, Hoover Andrew, Buatti John

机构信息

1 Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.

2 Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa, USA.

出版信息

Ann Otol Rhinol Laryngol. 2018 Mar;127(3):185-191. doi: 10.1177/0003489417751474. Epub 2018 Jan 9.

Abstract

OBJECTIVES

To evaluate the performance of surveillance F-18 fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) 1 year after imaging in oral squamous cell carcinoma (OSCC) patients treated with definitive surgery and adjuvant (chemo)radiotherapy (RT).

METHODS AND MATERIALS

Surveillance PET/CT accuracy was retrospectively evaluated in OSCC patients receiving surgical resection and (chemo)RT. Pathologic risk factors were assessed for influence on accuracy of the post-RT PET/CT.

RESULTS

Fifty-four patients with median follow-up of 3.8 years met inclusion criteria. A PET/CT obtained a median of 3.4 months after RT revealed 11 (20.4%) instances of true disease recurrence: 4 locoregional alone, 6 distant alone, and 1 patient with locoregional and distant disease. Locoregional detection sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 55.6%, 75.0%, 33.3%, and 88.2%, respectively. For distant recurrence, the respective values were 100%, 95.2%, 77.8%, and 100%. Absence of bone invasion, absence of pT4 disease, and disease within the tongue were independently associated with higher sensitivity ( P = .048). Perineural invasion was associated with increased specificity ( P = .027), and tumor location in the tongue was associated with a higher PPV ( P = .007) on surveillance PET/CT.

CONCLUSIONS

Post-RT PET/CT accuracy information for surgically managed OSCC patients demonstrates significant associations with pathologic factors.

摘要

目的

评估接受根治性手术及辅助(化疗)放疗(RT)的口腔鳞状细胞癌(OSCC)患者在成像后1年进行的监测F-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(PET/CT)的性能。

方法和材料

对接受手术切除及(化疗)放疗的OSCC患者的监测PET/CT准确性进行回顾性评估。评估病理危险因素对放疗后PET/CT准确性的影响。

结果

54例中位随访时间为3.8年的患者符合纳入标准。放疗后中位3.4个月进行的PET/CT显示11例(20.4%)真正的疾病复发:4例仅为局部区域复发,6例仅为远处复发,1例患者同时有局部区域和远处疾病。局部区域检测的敏感性、特异性、阳性预测值(PPV)和阴性预测值(NPV)分别为55.6%、75.0%、33.3%和88.2%。对于远处复发,相应的值分别为100%、95.2%、77.8%和100%。无骨侵犯、无pT4期疾病以及病变位于舌部与更高的敏感性独立相关(P = .048)。神经周围侵犯与特异性增加相关(P = .027),舌部的肿瘤位置与监测PET/CT上更高的PPV相关(P = .007)。

结论

手术治疗的OSCC患者放疗后PET/CT准确性信息与病理因素存在显著关联。

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