[F]FDG-PET和[F]FLT-PET参数对疑似放射性肺癌复发患者的影响。

Impact of [F]FDG-PET and [F]FLT-PET-Parameters in Patients with Suspected Relapse of Irradiated Lung Cancer.

作者信息

Christensen Tine N, Langer Seppo W, Persson Gitte, Larsen Klaus Richter, Amtoft Annemarie G, Keller Sune H, Kjaer Andreas, Fischer Barbara Malene

机构信息

Department of Clinical Physiology, Nuclear Medicine & PET, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen Ø, Denmark.

Cluster for Molecular Imaging, University of Copenhagen, 2200 Copenhagen N, Denmark.

出版信息

Diagnostics (Basel). 2021 Feb 11;11(2):279. doi: 10.3390/diagnostics11020279.

Abstract

Radiation-induced changes may cause a non-malignant high 2-deoxy-2-[F]fluoro-d-glucose (FDG)-uptake. The 3'-deoxy-3'-[F]fluorothymidine (FLT)-PET/CT performs better in the differential diagnosis of inflammatory changes and lung lesions with a higher specificity than FDG-PET/CT. We investigated the association between post-radiotherapy FDG-PET-parameters, FLT-PET-parameters, and outcome. Sixty-one patients suspected for having a relapse after definitive radiotherapy for lung cancer were included. All the patients had FDG-PET/CT and FLT-PET/CT. FDG-PET- and FLT-PET-parameters were collected from within the irradiated high-dose volume (HDV) and from recurrent pulmonary lesions. For associations between PET-parameters and relapse status, respectively, the overall survival was analyzed. Thirty patients had a relapse, of these, 16 patients had a relapse within the HDV. FDG-SUV and FLT-SUV were higher in relapsed HDVs compared with non-relapsed HDVs (median FDG-SUV: 12.8 vs. 4.2; < 0.001; median FLT-SUV 3.9 vs. 2.2; < 0.001). A relapse within HDV had higher FDG-SUV (median FDG-SUV: 7.1 vs. 3.5; = 0.014) and was larger (median metabolic tumor volume (MTV): 2.5 vs. 0.7; 0.014) than the relapsed lesions outside of HDV. The proliferative tumor volume (PTV) was prognostic for the overall survival (hazard ratio: 1.07 pr cm [1.01-1.13]; = 0.014) in the univariate analysis, but not in the multivariate analysis. FDG-SUV and FLT-SUV may be helpful tools for differentiating the relapse from radiation-induced changes, however, they should not be used definitively for relapse detection.

摘要

辐射诱导的变化可能导致非恶性的高2-脱氧-2-[F]氟-D-葡萄糖(FDG)摄取。3'-脱氧-3'-[F]氟胸苷(FLT)-PET/CT在炎症变化和肺部病变的鉴别诊断中表现更佳,其特异性高于FDG-PET/CT。我们研究了放疗后FDG-PET参数、FLT-PET参数与预后之间的关联。纳入了61例在肺癌根治性放疗后疑似复发的患者。所有患者均接受了FDG-PET/CT和FLT-PET/CT检查。从照射的高剂量体积(HDV)内以及复发性肺部病变处收集FDG-PET和FLT-PET参数。分别分析PET参数与复发状态之间的关联以及总生存期。30例患者出现复发,其中16例在HDV内复发。与未复发的HDV相比,复发的HDV中FDG-SUV和FLT-SUV更高(中位FDG-SUV:12.8对4.2;<0.001;中位FLT-SUV 3.9对2.2;<0.001)。HDV内的复发灶FDG-SUV更高(中位FDG-SUV:7.1对3.5;=0.014)且体积更大(中位代谢肿瘤体积(MTV):2.5对0.7;0.014),比HDV外的复发灶大。在单因素分析中,增殖肿瘤体积(PTV)对总生存期具有预后意义(风险比:每厘米1.07 [1.01 - 1.13];=0.014),但在多因素分析中无此意义。FDG-SUV和FLT-SUV可能是区分复发与辐射诱导变化的有用工具,然而,它们不应被绝对用于复发检测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59d6/7916960/8e83d98e2a4f/diagnostics-11-00279-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索