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使用源自F-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描的影像参数对胰腺癌根治性手术后的预后进行预测。

Prognosis prediction of pancreatic cancer after curative intent surgery using imaging parameters derived from F-18 fluorodeoxyglucose positron emission tomography/computed tomography.

作者信息

Yoo Min Young, Yoon Yoo-Seok, Suh Min Seok, Cho Jai Young, Han Ho-Seong, Lee Won Woo

机构信息

Departments of Nuclear Medicine, Chungbuk National University Hospital, Cheongju.

Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam.

出版信息

Medicine (Baltimore). 2020 Aug 28;99(35):e21829. doi: 10.1097/MD.0000000000021829.

Abstract

Imaging parameters including metabolic or textural parameters during F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) are being used for evaluation of malignancy. However, their utility for prognosis prediction has not been thoroughly investigated. Here, we evaluated the prognosis prediction ability of imaging parameters from preoperative FDGPET/CT in operable pancreatic cancer patients.Sixty pancreatic cancer patients (male:female = 36:24, age = 67.2 ± 10.5 years) who had undergone FDGPET/CT before the curative intent surgery were enrolled. Clinico-pathologic parameters, metabolic parameters from FDGPET/CT; maximal standard uptake value (SUVmax), glucose-incorporated SUVmax (GI-SUVmax), metabolic tumor volume, total-lesion glycolysis, and 53 textural parameters derived from imaging analysis software (MaZda version 4.6) were compared with overall survival.All the patients underwent curative resection. Mean and standard deviation of overall follow-up duration was 16.12 ± 9.81months. Among them, 39 patients had died at 13.46 ± 8.82 months after operation, whereas 21 patients survived with the follow-up duration of 18.56 ± 9.97 months. In the univariate analysis, Tumor diameter ≥4 cm (P = .003), Preoperative Carbohydrate antigen 19-9 ≥37 U/mL (P = .034), number of metastatic lymph node (P = .048) and GI-SUVmax (P = .004) were significant parameters for decreased overall survival. Among the textural parameters, kurtosis3D (P = .052), and skewness3D (P = .064) were potentially significant predictors in the univariate analysis. However, in multivariate analysis only GI-SUVmax (P = .026) and combined operation (P = .001) were significant independent predictors of overall survival.The current research result indicates that metabolic parameter (GI-SUVmax) from FDGPET/CT, and combined operation could predict the overall survival of surgically resected pancreatic cancer patients. Other metabolic or textural imaging parameters were not significant predictors for overall survival of localized pancreatic cancer.

摘要

包括18F-氟脱氧葡萄糖(FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)期间的代谢或纹理参数在内的成像参数正被用于评估恶性肿瘤。然而,它们在预后预测方面的效用尚未得到充分研究。在此,我们评估了术前FDG PET/CT成像参数对可手术切除的胰腺癌患者的预后预测能力。

纳入了60例在进行根治性手术前接受过FDG PET/CT检查的胰腺癌患者(男:女 = 36:24,年龄 = 67.2±10.5岁)。将临床病理参数、FDG PET/CT的代谢参数;最大标准摄取值(SUVmax)、葡萄糖掺入SUVmax(GI-SUVmax)、代谢肿瘤体积、总病变糖酵解以及从成像分析软件(MaZda版本4.6)得出的53个纹理参数与总生存期进行比较。

所有患者均接受了根治性切除。总随访时间的均值和标准差为16.12±9.81个月。其中,39例患者在术后13.46±8.82个月死亡,而21例患者存活,随访时间为18.56±9.97个月。在单因素分析中,肿瘤直径≥4 cm(P = 0.003)、术前糖类抗原19-9≥37 U/mL(P = 0.034)、转移淋巴结数量(P = 0.048)和GI-SUVmax(P = 0.004)是总生存期降低的显著参数。在纹理参数中,三维峰度(P = 0.052)和三维偏度(P = 0.064)在单因素分析中是潜在的显著预测因子。然而,在多因素分析中,只有GI-SUVmax(P = 0.026)和联合手术(P = 0.001)是总生存期的显著独立预测因子。

当前的研究结果表明,FDG PET/CT的代谢参数(GI-SUVmax)和联合手术可以预测手术切除的胰腺癌患者的总生存期。其他代谢或纹理成像参数不是局部胰腺癌总生存期的显著预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8e95/7458160/614791416834/medi-99-e21829-g001.jpg

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