FDG-PET 参数预测肛门癌复发 - 一项前瞻性、多中心临床试验的结果。
FDG-PET parameters predict for recurrence in anal cancer - results from a prospective, multicentre clinical trial.
机构信息
WP Holman Clinic, Royal Hobart Hospital, Hobart, Tasmania, Australia.
The University of Newcastle, Callaghan, New South Wales, Australia.
出版信息
Radiat Oncol. 2019 Aug 6;14(1):140. doi: 10.1186/s13014-019-1342-9.
BACKGROUND
To investigate the prognostic significance of positron emission tomography (PET) parameters from F-18 fluorodeoxyglucose (FDG) PET scans performed pre- and post- chemo-radiotherapy (CRT) for squamous cell carcinoma of the anal canal (AC).
METHODS
From January 2013 to January 2017, 19 patients with non-metastatic AC enrolled on a prospective trial underwent FDG-PET/CT imaging before and 12 weeks following CRT. A computer-generated volume of interest (VOI) was snapped around the primary tumour using six different standard uptake value (SUV) thresholds and the following parameters were extracted: SUV max, mean, median, standard deviation and peak as well as metabolic tumour volume (MTV) and total lesion glycolysis. Exact logistic regression and ROC AUC analyses were performed for each metric at each timepoint.
RESULTS
With a median follow up of 15.8 months, 3/19 patients had a local recurrence and 5/19 had any recurrence. On post-CRT PET, the median SUV within a VOI bounded by an SUV of 3 correlated with local recurrence (p < 0.01) and demonstrated excellent discrimination (ROC AUC 1.00, perfect separation was achieved at a median SUV of 3.38). The mean SUV at this threshold did not quite reach significance for prediction of local recurrence (p = 0.06) but demonstrated excellent discrimination (ROC AUC 0.91). The MTV bounded by a threshold of 41% SUVmax on the pre-CRT PET predicted for any recurrence (p = 0.03) and showed excellent discrimination (ROC AUC 0.89).
CONCLUSIONS
FDG-PET parameters are predictive of recurrence in AC. FDG-PET may represent a valuable tool for prognostication and response assessment in AC.
TRIAL REGISTRATION
ANZCTR, ACTRN12614001219673 . Registered 19 November 2014 - Retrospectively registered.
背景
研究氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）在接受放化疗（CRT）前后的预测价值，以评估肛门鳞癌（AC）的预后。
方法
从 2013 年 1 月到 2017 年 1 月，19 名非转移性 AC 患者参加了一项前瞻性试验，在 CRT 前和 12 周后进行 FDG-PET/CT 成像。使用 6 种不同的标准摄取值（SUV）阈值，使用计算机生成的感兴趣区（VOI）来围绕原发肿瘤进行勾画，并提取以下参数：SUVmax、平均值、中位数、标准差和峰值，以及代谢肿瘤体积（MTV）和总病变糖酵解。对每个时间点的每个指标进行精确逻辑回归和 ROC AUC 分析。
结果
中位随访 15.8 个月，3/19 例患者出现局部复发，5/19 例患者出现任何复发。在 CRT 后 PET 上，使用 SUV 为 3 的 VOI 边界内的 SUV 中位数与局部复发相关（p<0.01），具有极好的鉴别力（ROC AUC 为 1.00，在 SUV 中位数为 3.38 时达到完美分离）。在此阈值下的平均 SUV 用于预测局部复发尚未达到显著意义（p=0.06），但具有极好的鉴别力（ROC AUC 为 0.91）。在 CRT 前 PET 上，使用 SUVmax 的 41%阈值边界内的 MTV 预测任何复发（p=0.03），并具有极好的鉴别力（ROC AUC 为 0.89）。
结论
FDG-PET 参数可预测 AC 的复发。FDG-PET 可能是评估 AC 预后和反应的有价值工具。
试验注册
ANZCTR，ACTRN12614001219673。于 2014 年 11 月 19 日注册-回顾性注册。
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