胰腺腺癌患者 CT 衰减值和 FDG 摄取的预后价值。

Prognostic value of CT attenuation and FDG uptake of adipose tissue in patients with pancreatic adenocarcinoma.

机构信息

Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St Mary's Hospital, Simgokro 100 Gil 25, Seo-gu, Incheon, 22711, South Korea; Department of Radiology, Graduate School, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.

Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, 23-20 Byeongmyeong-dong, Dongnam-gu, Cheonan, Chungcheongnam-do, 31151, South Korea.

出版信息

Clin Radiol. 2018 Dec;73(12):1056.e1-1056.e10. doi: 10.1016/j.crad.2018.07.094. Epub 2018 Aug 1.

DOI:10.1016/j.crad.2018.07.094

PMID:30077337

Abstract

AIM

To investigate the prognostic significance of computed tomography (CT) attenuation and 2-[F]-fluoro-2-deoxy-d-glucose (FDG) uptake in subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) for predicting overall survival (OS) in patients with pancreatic adenocarcinoma.

MATERIALS AND METHODS

Data were collected retrospectively from 66 patients with pancreatic adenocarcinoma who had undergone pretreatment combined FDG positron-emission tomography (PET)/CT imaging and subsequent curative or palliative treatment. Metabolic parameters of primary tumour including total lesion glycolysis (TLG) and heterogeneity factor were measured. Volume, CT attenuation (attenuation), and FDG uptake of SAT and VAT were derived from PET/CT acquisitions. Survival analysis using Cox proportional hazard modelling was performed to assess the relationship between both attenuation and FDG uptake of fat tissue and OS.

RESULTS

During follow-up, 33 patients (50%) died and the median OS was 12 months. There were significant positive correlations between attenuation and mean standardised uptake values of both SAT (p<0.001, r=0.697) and VAT (p<0.001, r=0.742). Attenuation and FDG uptake of adipose tissue were significantly associated with heterogeneity factor and T stage. Patients with high FDG uptake and attenuation of SAT and VAT had significantly worse OS than those with low values. On multivariate analysis, attenuation of SAT (p=0.047) and VAT (p=0.021), and FDG uptake of VAT (p=0.005) were correlated significantly with OS after adjusting for age, sex, body mass index, TNM stage, and TLG.

CONCLUSIONS

CT attenuation of SAT and VAT, and FDG uptake of VAT significantly correlated with OS in patients with pancreatic adenocarcinoma, independent of TNM staging and TLG.

摘要

目的

研究计算机断层扫描（CT）衰减和 2-[F]-氟-2-脱氧-D-葡萄糖（FDG）在皮下脂肪组织（SAT）和内脏脂肪组织（VAT）中的摄取对预测胰腺腺癌患者总生存期（OS）的预后意义。

材料和方法

回顾性收集了 66 例接受术前联合 FDG 正电子发射断层扫描（PET）/CT 成像及随后根治或姑息治疗的胰腺腺癌患者的数据。测量了原发肿瘤的代谢参数，包括总病变糖酵解（TLG）和异质性因子。从 PET/CT 采集获得 SAT 和 VAT 的体积、CT 衰减（attenuation）和 FDG 摄取。使用 Cox 比例风险模型进行生存分析，以评估脂肪组织衰减和 FDG 摄取与 OS 的关系。

结果

在随访期间，33 例患者（50%）死亡，中位 OS 为 12 个月。SAT（p<0.001，r=0.697）和 VAT（p<0.001，r=0.742）的 SAT 和 VAT 的衰减与平均标准化摄取值之间存在显著正相关。脂肪组织的衰减和 FDG 摄取与异质性因子和 T 期显著相关。SAT 和 VAT 的高 FDG 摄取和衰减的患者 OS 明显比低值患者差。多变量分析显示，在调整年龄、性别、体重指数、TNM 分期和 TLG 后，SAT（p=0.047）和 VAT（p=0.021）的衰减以及 VAT 的 FDG 摄取（p=0.005）与 OS 显著相关。