[F]FES和[F]FDHT PET对转移性乳腺癌患者的视觉和定量评估：一项观察者间变异性研究
Visual and quantitative evaluation of [F]FES and [F]FDHT PET in patients with metastatic breast cancer: an interobserver variability study.
作者信息
Mammatas Lemonitsa H, Venema Clasina M, Schröder Carolina P, de Vet Henrica C W, van Kruchten Michel, Glaudemans Andor W J M, Yaqub Maqsood M, Verheul Henk M W, Boven Epie, van der Vegt Bert, de Vries Erik F J, de Vries Elisabeth G E, Hoekstra Otto S, Hospers Geke A P, der Houven van Oordt C Willemien Menke-van
机构信息
Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, VUmc University Medical Center Amsterdam, de Boelelaan 1117, 1081, HV, Amsterdam, The Netherlands.
Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713, GZ, Groningen, The Netherlands.
出版信息
EJNMMI Res. 2020 Apr 19;10(1):40. doi: 10.1186/s13550-020-00627-z.
PURPOSE
Correct identification of tumour receptor status is important for treatment decisions in breast cancer. [F]FES PET and [F]FDHT PET allow non-invasive assessment of the oestrogen (ER) and androgen receptor (AR) status of individual lesions within a patient. Despite standardised analysis techniques, interobserver variability can significantly affect the interpretation of PET results and thus clinical applicability. The purpose of this study was to determine visual and quantitative interobserver variability of [F]FES PET and [F]FDHT PET interpretation in patients with metastatic breast cancer.
METHODS
In this prospective, two-centre study, patients with ER-positive metastatic breast cancer underwent both [F]FES and [F]FDHT PET/CT. In total, 120 lesions were identified in 10 patients with either conventional imaging (bone scan or lesions > 1 cm on high-resolution CT, n = 69) or only with [F]FES and [F]FDHT PET (n = 51). All lesions were scored visually and quantitatively by two independent observers. A visually PET-positive lesion was defined as uptake above background. For quantification, we used standardised uptake values (SUV): SUV, SUV and SUV.
RESULTS
Visual analysis showed an absolute positive and negative interobserver agreement for [F]FES PET of 84% and 83%, respectively (kappa = 0.67, 95% CI 0.48-0.87), and 49% and 74% for [F]FDHT PET, respectively (kappa = 0.23, 95% CI - 0.04-0.49). Intraclass correlation coefficients (ICC) for quantification of SUV, SUV and SUV were 0.98 (95% CI 0.96-0.98), 0.97 (95% CI 0.96-0.98) and 0.89 (95% CI 0.83-0.92) for [F]FES, and 0.78 (95% CI 0.66-0.85), 0.76 (95% CI 0.63-0.84) and 0.75 (95% CI 0.62-0.84) for [F]FDHT, respectively.
CONCLUSION
Visual and quantitative evaluation of [F]FES PET showed high interobserver agreement. These results support the use of [F]FES PET in clinical practice. In contrast, visual agreement for [F]FDHT PET was relatively low due to low tumour-background ratios, but quantitative agreement was good. This underscores the relevance of quantitative analysis of [F]FDHT PET in breast cancer.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT01988324. Registered 20 November 2013, https://clinicaltrials.gov/ct2/show/NCT01988324?term=FDHT+PET&draw=1&rank=2.
目的
准确识别肿瘤受体状态对于乳腺癌的治疗决策至关重要。[F]FES PET和[F]FDHT PET能够对患者体内单个病灶的雌激素（ER）和雄激素受体（AR）状态进行无创评估。尽管采用了标准化分析技术，但观察者间的变异性仍会显著影响PET结果的解读，进而影响其临床适用性。本研究旨在确定转移性乳腺癌患者中[F]FES PET和[F]FDHT PET解读的视觉和定量观察者间变异性。
方法
在这项前瞻性、多中心研究中，ER阳性转移性乳腺癌患者接受了[F]FES和[F]FDHT PET/CT检查。共有10例患者的120个病灶被识别出来，其中69个病灶通过传统成像（骨扫描或高分辨率CT上>1 cm的病灶）发现，51个病灶仅通过[F]FES和[F]FDHT PET发现。所有病灶均由两名独立观察者进行视觉和定量评分。视觉上PET阳性病灶定义为摄取高于背景。为进行定量分析，我们使用了标准化摄取值（SUV）：SUV、SUV和SUV。
结果
视觉分析显示，[F]FES PET的观察者间绝对阳性和阴性一致性分别为84%和83%（kappa = 0.67，95% CI 0.48 - 0.87），[F]FDHT PET分别为49%和74%（kappa = 0.
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