Nakamoto Ryusuke, Zaba Lisa C, Rosenberg Jarrett, Reddy Sunil Arani, Nobashi Tomomi Watanabe, Davidzon Guido, Aparici Carina Mari, Nguyen Judy, Moradi Farshad, Iagaru Andrei, Franc Benjamin Lewis
Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Stanford University, 300 Pasteur Drive, Stanford, CA, 94305-5281, USA.
Department of Dermatology, Stanford University, Stanford, USA.
Eur J Nucl Med Mol Imaging. 2020 Nov;47(12):2787-2795. doi: 10.1007/s00259-020-04792-0. Epub 2020 Apr 15.
The purpose of this study was to investigate the prognostic value of whole-body metabolic tumor volume (MTV) and other metabolic tumor parameters, obtained from baseline and first restaging F-FDG PET/CT scans in melanoma patients treated with immune checkpoint inhibitors (ICIs).
Eighty-five consecutive melanoma patients (M, 57; F, 28) treated with ICIs who underwent PET/CT scans before and approximately 3 months after the start of immunotherapy were retrospectively enrolled. Metabolic tumor parameters including MTV for all melanoma lesions were measured on each scan. A Cox proportional hazards model was used for univariate and multivariate analyses of metabolic parameters combined with known clinical prognostic factors associated with overall survival (OS). Kaplan-Meier curves for patients dichotomized based on median values of imaging parameters were generated.
The median OS time in all patients was 45 months (95% CI 24-45 months). Univariate analysis demonstrated that MTV obtained from first restaging PET/CT scans (MTVpost) was the strongest prognostic factor for OS among PET/CT parameters (P < 0.0001). The median OS in patients with high MTVpost (≥ 23.44) was 16 months (95% CI 12-32 months) as compared with more than 60 months in patients with low MTVpost (< 23.44) (P = 0.0003). A multivariate model including PET/CT parameters and known clinical prognostic factors revealed that MTVpost and the presence of central nervous system lesions were independent prognostic factors for OS (P = 0.0004, 0.0167, respectively). One pseudoprogression case (1.2%) was seen in this population and classified into the high MTVpost group.
Whole-body metabolic tumor volume from PET scan acquired approximately 3 months following initiation of immunotherapy (MTVpost) is a strong prognostic indicator of OS in melanoma patients. Although the possibility of pseudoprogression must be considered whenever evaluating first restaging PET imaging, it only occurred in 1 patient in our cohort.
本研究旨在探讨在接受免疫检查点抑制剂（ICI）治疗的黑色素瘤患者中，从基线和首次再分期F-FDG PET/CT扫描获得的全身代谢肿瘤体积（MTV）及其他代谢肿瘤参数的预后价值。
回顾性纳入85例连续接受ICI治疗的黑色素瘤患者（男性57例，女性28例），这些患者在免疫治疗开始前及开始后约3个月接受了PET/CT扫描。在每次扫描上测量所有黑色素瘤病灶的包括MTV在内的代谢肿瘤参数。采用Cox比例风险模型对代谢参数与已知的与总生存期（OS）相关的临床预后因素进行单因素和多因素分析。根据成像参数的中位数对患者进行二分法划分，生成Kaplan-Meier曲线。
所有患者的中位OS时间为45个月（95%CI 24 - 45个月）。单因素分析表明，从首次再分期PET/CT扫描获得的MTV（MTVpost）是PET/CT参数中OS最强的预后因素（P < 0.0001）。MTVpost高（≥23.44）的患者中位OS为16个月（95%CI
