治疗前F-FAMT PET/CT代谢肿瘤体积在非小细胞肺癌中的预后价值。

Prognostic value of metabolic tumor volume of pretreatment F-FAMT PET/CT in non-small cell lung Cancer.

作者信息

Kumasaka Soma, Nakajima Takahito, Arisaka Yukiko, Tokue Azusa, Achmad Arifudin, Fukushima Yasuhiro, Shimizu Kimihiro, Kaira Kyoichi, Higuchi Tetsuya, Tsushima Yoshito

机构信息

Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Showa-machi 3-39-22, Maebashi, Gunma, 371-8511, Japan.

Department of Nuclear Medicine and Molecular Imaging Faculty of Medicine, Universitas Padjadjaran Jalan Professor Eyckman No.38, Bandung, Jawa Barat, 40161, Indonesia.

出版信息

BMC Med Imaging. 2018 Nov 26;18(1):46. doi: 10.1186/s12880-018-0292-2.

BACKGROUND

This study aimed to determine the prognostic value of positron emission tomography (PET) metabolic parameters-namely metabolic tumor volume (MTV), total lesion glycolysis (TLG), and total lesion retention (TLR)-on fluorine-18 (F) fluorodeoxyglucose (FDG) and L- [3-F]-α-methyltyrosine (F-FAMT) PET/CT in patients with non-small-cell lung cancer (NSCLC).

METHODS

The study group comprised 112 NSCLC patients who underwent F-FDG and F-FAMT PET/CT prior to any therapy. The MTV, TLG, TLR, and maximum standardized uptake value (SUV) of the primary tumors were determined. Automatic MTV measurement was performed using PET volume computer assisted reading software. (GE Healthcare). Cox proportional hazards models were built to assess the prognostic value of MTV, TLG (for F-FDG), TLR (for F-FAMT), SUV, T stage, N stage, M stage, clinical stage, age, sex, tumor histological subtype, and treatment method (surgery or other therapy) on overall survival (OS).

RESULTS

Higher TNM, higher clinical stage, inoperable status, and higher values for all PET parameters (both F-FAMT and F-FDG PET) were significantly associated (P < 0.05) with shorter OS. Multivariate analysis revealed that a higher MTV of F-FAMT (hazard ratio [HR]: 2.88, CI: 1.63-5.09, P < 0.01) and advanced clinical stage (HR: 5.36, CI: 1.88-15.34, P < 0.01) were significant predictors of shorter OS.

CONCLUSIONS

MTV of F-FAMT is of prognostic value for OS in NSCLC cases and can help guide decision-making during patient management.

背景

本研究旨在确定正电子发射断层扫描（PET）代谢参数，即代谢肿瘤体积（MTV）、总病灶糖酵解（TLG）和总病灶滞留（TLR），对非小细胞肺癌（NSCLC）患者进行氟-18（F）氟脱氧葡萄糖（FDG）和L-[3-F]-α-甲基酪氨酸（F-FAMT）PET/CT检查的预后价值。

方法

研究组包括112例NSCLC患者，这些患者在接受任何治疗之前均接受了F-FDG和F-FAMT PET/CT检查。测定了原发肿瘤的MTV、TLG、TLR和最大标准化摄取值（SUV）。使用PET体积计算机辅助阅读软件（GE医疗）进行自动MTV测量。构建Cox比例风险模型，以评估MTV、TLG（针对F-FDG）、TLR（针对F-FAMT）、SUV、T分期、N分期、M分期、临床分期、年龄、性别、肿瘤组织学亚型和治疗方法（手术或其他治疗）对总生存期（OS）的预后价值。

结果

更高的TNM分期、更高的临床分期、无法手术的状态以及所有PET参数（F-FAMT和F-FDG PET）的更高值均与较短的OS显著相关（P < 0.05）。多变量分析显示，F-FAMT的更高MTV（风险比[HR]：2.88，置信区间[CI]：1.63 - 5.09，P < 0.01）和晚期临床分期（HR：5.36，CI：1.88 - 15.34，P < 0.01）是较短OS的显著预测因素。