18F-氟脱氧葡萄糖衍生的生物学助推剂在鳞状细胞分析癌中是否有作用？

Is There a Role for an 18F-fluorodeoxyglucose-derived Biological Boost in Squamous Cell Anal Cancer?

机构信息

Department of Oncology, Oxford University Hospitals Trust, Oxford, UK.

Department of Oncology, Oxford University Hospitals Trust, Oxford, UK; CRUK MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK.

出版信息

Clin Oncol (R Coll Radiol). 2019 Feb;31(2):72-80. doi: 10.1016/j.clon.2018.11.034. Epub 2018 Dec 21.

DOI:10.1016/j.clon.2018.11.034

PMID:30583927

Abstract

AIMS

To investigate the potential role for a biological boost in anal cancer by assessing whether subvolumes of high 18F-fluorodeoxyglucose (FDG) avidity, identified at outset, are spatially consistent during a course of chemoradiotherapy (CRT).

MATERIALS AND METHODS

FDG-positron emission tomography (FDG-PET) scans from 21 patients enrolled into the ART study (NCT02145416) were retrospectively analysed. In total, 29 volumes including both primary tumours and involved nodes >2 cm were identified. FDG-PET scans were carried out before treatment and on day 8 or 9 of CRT. FDG subvolumes were created using a percentage of maximum FDG avidity at thresholds of 34%, 40%, 50%, on the pre-treatment scans, and 70% and 80% on the subsequent scans. Both FDG-PET scans were deformably registered to the planning computed tomography scan. The overlap fraction and the vector distance were calculated to assess spatial consistency. FDG subvolumes for further investigation had an overlap fraction >0.7, as this has been defined in previous publications as a 'good' correlation.

RESULTS

The median overlap fractions between the diagnostic FDG-PET subvolumes 34%, 40% and 50% of maximum standardised uptake value (SUV) and subsequent FDG-PET subvolumes of 70% of SUV were 0.97, 0.92 and 0.81. The median overlap fraction between the diagnostic FDG-PET subvolumes 34%, 40% and 50% and subsequent FDG-PET subvolumes of 80% were 1.00, 1.00 and 0.92. The median (range) vector distance values between diagnostic FDG-PET subvolumes 34%, 40% and 50% and subsequent FDG-PET subvolumes of 80% were 0.74 mm (0.19-2.94) 0.74 mm (0.19-3.39) and 0.71 mm (0.2-3.29), respectively. Twenty of 29 volumes (69.0%) achieved a threshold > 0.7 between the FDG 50% subvolume on the diagnostic scan and the FDG 80% subvolume on the subsequent scan.

CONCLUSION

FDG-avid subvolumes identified at baseline were spatially consistent during a course of CRT treatment. The subvolume of 50% of SUV on the pre-treatment scan could be considered as a potential target for dose escalation.

摘要

目的

通过评估在放化疗（CRT）过程中，起始时识别的高 18F-氟脱氧葡萄糖（FDG）摄取量的亚体积是否具有空间一致性，来研究生物增强在肛门癌中的潜在作用。

材料和方法

回顾性分析了 21 名参加 ART 研究（NCT02145416）的患者的 FDG 正电子发射断层扫描（FDG-PET）扫描。总共确定了 29 个包括原发肿瘤和>2cm 的受累淋巴结的体积。FDG-PET 扫描在治疗前和 CRT 的第 8 或第 9 天进行。在治疗前扫描中，使用最大 FDG 摄取量的 34%、40%、50%的百分比创建 FDG 亚体积，在后续扫描中使用 70%和 80%的百分比创建 FDG 亚体积。对两次 FDG-PET 扫描进行可变形配准到计划计算机断层扫描。使用重叠分数和向量距离来评估空间一致性。进一步研究的 FDG 亚体积的重叠分数>0.7，因为这在以前的出版物中已定义为“良好”相关性。

结果

最大标准化摄取量（SUV）的诊断 FDG-PET 亚体积 34%、40%和 50%与 SUV 后续 FDG-PET 亚体积 70%之间的中位数重叠分数分别为 0.97、0.92 和 0.81。最大 SUV 的诊断 FDG-PET 亚体积 34%、40%和 50%与 SUV 后续 FDG-PET 亚体积 80%之间的中位数重叠分数为 1.00、1.00 和 0.92。诊断 FDG-PET 亚体积 34%、40%和 50%与 SUV 后续 FDG-PET 亚体积 80%之间的中位数（范围）向量距离值分别为 0.74mm（0.19-2.94）、0.74mm（0.19-3.39）和 0.71mm（0.2-3.29）。29 个体积中有 20 个（69.0%）在诊断扫描的 FDG 50%亚体积和后续扫描的 FDG 80%亚体积之间达到了>0.7 的阈值。