基于 Ga-DOTATATE PET/CT 计算的生长抑素受体表达肿瘤体积对分化型神经内分泌肿瘤患者的预后价值。
Prognostic value of somatostatin receptor expressing tumor volume calculated from Ga-DOTATATE PET/CT in patients with well-differentiated neuroendocrine tumors.
机构信息
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305-5281, USA.
Division of Oncology, Department of Medicine, Stanford University, 875 Blake Wilbur Dr, Stanford, CA, 94305-5826, USA.
出版信息
Eur J Nucl Med Mol Imaging. 2019 Oct;46(11):2244-2251. doi: 10.1007/s00259-019-04455-9. Epub 2019 Jul 27.
PURPOSE
To evaluate the prognostic value of volumetric parameters calculated from Ga-1,4,7,10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid (DOTA)-Thr-octreotate (Ga-DOTATATE) positron emission tomography/computed tomography (PET/CT) in patients with well-differentiated neuroendocrine tumor (WD-NET).
METHODS
Ninety-two patients (44 men and 48 women, mean age of 59.5-year-old) with pathologically confirmed WD-NET (grades 1 or 2) were enrolled in a prospective expanded access protocol. Selected data was analyzed retrospectively for this project. Maximum standardized uptake value (SUV) in the lesion with the highest Ga-DOTATATE uptake was measured and recorded for each patient. In addition, two volumetric parameters, namely, somatostatin receptor expressing tumor volume (SRETV) and total lesion somatostatin receptor expression (TLSRE), were calculated in each Ga-DOTATATE-avid lesion. SRETV was defined as tumor volume with higher Ga-DOTATATE uptake than the 50% of SUV within the volume of interest (VOI) for each lesion. TLSRE was calculated by multiplying SRETV and mean SUV within the same VOI. Thereafter, the sum of SRETV (ΣSRETV) and TLSRE (ΣTLSRE) for all detected lesions per patient were calculated. Progression-free survival (PFS) was set as primary endpoint. Kaplan-Meier survival analysis, log-rank test, and Cox's proportional hazard model were used for statistical analysis.
RESULTS
Univariate analyses revealed significant difference of PFS for WHO tumor grade and ΣSRETV (P < 0.05), while there were no significant differences in age, sex, SUV, and ΣTLSRE (P > 0.05). Multivariate analysis identified WHO tumor grade and ΣSRETV as independent predictors of PFS.
CONCLUSION
ΣSRETV calculated from Ga-DOTATATE PET/CT may have prognostic value of PFS in WD-NET patients.
目的
评估基于 Ga-1,4,7,10-四氮杂环十二烷-1,4,7,10-四乙酸（DOTA）-苏氨酸-octreotate（Ga-DOTATATE）正电子发射断层扫描/计算机断层扫描（PET/CT）计算的容积参数在分化良好的神经内分泌肿瘤（WD-NET）患者中的预后价值。
方法
92 名（44 名男性和 48 名女性，平均年龄 59.5 岁）经病理证实为 WD-NET（1 级或 2 级）的患者入组前瞻性扩大准入方案。为该项目回顾性分析了选定的数据。测量并记录每位患者病变中摄取 Ga-DOTATATE 最高的病变的最大标准化摄取值（SUV）。此外，在每个 Ga-DOTATATE 阳性病变中计算了两个容积参数，即生长抑素受体表达肿瘤体积（SRETV）和总病变生长抑素受体表达（TLSRE）。SRETV 定义为肿瘤体积，其 Ga-DOTATATE 摄取量高于每个病变感兴趣容积（VOI）内 SUV 的 50%。TLSRE 通过将 SRETV 与同一 VOI 内的平均 SUV 相乘计算。然后，计算每位患者所有检测到的病变的 SRETV 总和（ΣSRETV）和 TLSRE 总和（ΣTLSRE）。无进展生存期（PFS）为主要终点。Kaplan-Meier 生存分析、对数秩检验和 Cox 比例风险模型用于统计分析。
结果
单因素分析显示 PFS 在 WHO 肿瘤分级和 ΣSRETV 方面存在显著差异（P<0.05），而年龄、性别、SUV 和 ΣTLSRE 方面无显著差异（P>0.05）。多因素分析确定 WHO 肿瘤分级和 ΣSRETV 为 PFS 的独立预测因子。
结论
基于 Ga-DOTATATE PET/CT 计算的 ΣSRETV 可能对 WD-NET 患者的 PFS 具有预后价值。
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