Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan; Department of Nuclear Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
Oral Oncol. 2020 May;104:104628. doi: 10.1016/j.oraloncology.2020.104628. Epub 2020 Mar 9.
The aim of the present study was to evaluate whether texture features extracted from F-FDG PET/CT images may provide additional prognostic information in patients with metastatic nasopharyngeal carcinoma (NPC).
We retrospectively examined 52 patients with metastatic NPC who underwent assessment of EBV DNA titers and pretreatment F-FDG PET/CT imaging. All participants were followed up for at least two years. The following F-FDG PET parameters were analyzed: standardized uptake value (SUV), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and texture parameters. Independent predictors of outcomes were identified using receiver operating characteristic curve analysis and multivariate Cox proportional hazards models.
On multivariate analysis, EBV DNA titers > 3500 copies/mL and TLG of metastatic lesions > 138 mL were identified as independent predictors of overall survival (OS) (P = 0.036 and P = 0.047, respectively). Patients were divided into two subgroups based on their EBV DNA titers (high versus low). In the high EBV DNA titer group, a lower homogeneity of distant metastatic lesions and higher TLG values of distant metastatic lesions were independent risk factors for OS (P = 0.033 and P < 0.001, respectively). In the low EBV DNA titer group, a reduced uniformity of distant metastatic lesions and a higher SUVmax of distant metastatic lesions were unfavorable risk factors for OS (P = 0.004 and P = 0.005, respectively). Based on these results, we devised two prognostic scoring systems for the prediction of 2-year OS in each EBV DNA titer group.
Some of the PET-derived texture parameters are independent predictors of outcomes in patients with metastatic NPC and provide complementary information to EBV DNA titers.
本研究旨在评估 F-FDG PET/CT 图像纹理特征是否可为转移性鼻咽癌（NPC）患者提供额外的预后信息。
我们回顾性分析了 52 例接受 EBV DNA 滴度和 F-FDG PET/CT 检查的转移性 NPC 患者。所有患者均随访至少 2 年。分析了以下 F-FDG PET 参数：标准化摄取值（SUV）、代谢肿瘤体积（MTV）、总病灶糖酵解（TLG）和纹理参数。使用受试者工作特征曲线分析和多变量 Cox 比例风险模型确定预后的独立预测因素。
多变量分析显示，EBV DNA 滴度>3500 拷贝/ml 和转移灶 TLG>138ml 是总生存（OS）的独立预测因素（P=0.036 和 P=0.047）。根据 EBV DNA 滴度将患者分为两组（高与低）。在 EBV DNA 滴度高的组中，远处转移灶的异质性较低和远处转移灶的 TLG 值较高是 OS 的独立危险因素（P=0.033 和 P<0.001）。在 EBV DNA 滴度低的组中，远处转移灶的均匀性降低和远处转移灶的 SUVmax 升高是 OS 的不利危险因素（P=0.004 和 P=0.005）。基于这些结果，我们为每个 EBV DNA 滴度组制定了两种预测 2 年 OS 的预后评分系统。
一些 PET 衍生的纹理参数是转移性 NPC 患者结局的独立预测因素，并为 EBV DNA 滴度提供了补充信息。
