Toriihara Akira, Ohtake Makoto, Tateishi Kensuke, Hino-Shishikura Ayako, Yoneyama Tomohiro, Kitazume Yoshio, Inoue Tomio, Kawahara Nobutaka, Tateishi Ukihide
Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Departments of Neurosurgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Ann Nucl Med. 2018 May;32(4):264-271. doi: 10.1007/s12149-018-1241-4. Epub 2018 Feb 16.
The potential of positron emission tomography/computed tomography using Cu-diacetyl-bis (N-methylthiosemicarbazone) (Cu-ATSM PET/CT), which was originally developed as a hypoxic tracer, to predict therapeutic resistance and prognosis has been reported in various cancers. Our purpose was to investigate prognostic value of Cu-ATSM PET/CT in patients with glioma, compared to PET/CT using 2-deoxy-2-[F]fluoro-D-glucose (F-FDG).
56 patients with glioma of World Health Organization grade 2-4 were enrolled. All participants had undergone both Cu-ATSM PET/CT and F-FDG PET/CT within mean 33.5 days prior to treatment. Maximum standardized uptake value and tumor/background ratio were calculated within areas of increased radiotracer uptake. The prognostic significance for progression-free survival and overall survival were assessed by log-rank test and Cox's proportional hazards model.
Disease progression and death were confirmed in 37 and 27 patients in follow-up periods, respectively. In univariate analysis, there was significant difference of both progression-free survival and overall survival in age, tumor grade, history of chemoradiotherapy, maximum standardized uptake value and tumor/background ratio calculated using Cu-ATSM PET/CT. Multivariate analysis revealed that maximum standardized uptake value calculated using Cu-ATSM PET/CT was an independent predictor of both progression-free survival and overall survival (p < 0.05). In a subgroup analysis including patients of grade 4 glioma, only the maximum standardized uptake values calculated using Cu-ATSM PET/CT showed significant difference of progression-free survival (p < 0.05).
Cu-ATSM PET/CT is a more promising imaging method to predict prognosis of patients with glioma compared to F-FDG PET/CT.
正电子发射断层扫描/计算机断层扫描（PET/CT）使用双乙酰双（N-甲基硫代半卡巴腙）铜（Cu-ATSM PET/CT），其最初作为一种乏氧示踪剂开发，在多种癌症中预测治疗耐药性和预后的潜力已有报道。我们的目的是研究与使用2-脱氧-2-[F]氟-D-葡萄糖（F-FDG）的PET/CT相比，Cu-ATSM PET/CT在胶质瘤患者中的预后价值。
纳入56例世界卫生组织2-4级胶质瘤患者。所有参与者在治疗前平均33.5天内均接受了Cu-ATSM PET/CT和F-FDG PET/CT检查。在放射性示踪剂摄取增加的区域内计算最大标准化摄取值和肿瘤/背景比值。通过对数秩检验和Cox比例风险模型评估无进展生存期和总生存期的预后意义。
随访期间分别有37例和27例患者证实疾病进展和死亡。单因素分析显示，年龄、肿瘤分级、放化疗史、使用Cu-ATSM PET/CT计算的最大标准化摄取值和肿瘤/背景比值在无进展生存期和总生存期方面均存在显著差异。多因素分析显示，使用Cu-ATSM PET/CT计算的最大标准化摄取值是无进展生存期和总生存期的独立预测因子（p<0.05）。在包括4级胶质瘤患者的亚组分析中，只有使用Cu-ATSM PET/CT计算的最大标准化摄取值在无进展生存期方面显示出显著差异（p<0.05）。
与F-FDG PET/CT相比，Cu-ATSM PET/CT是一种更有前景的预测胶质瘤患者预后的成像方法。
