Lee Jeong Won, Park Sang-Heum, Ahn Hyein, Lee Sang Mi, Jang Su Jin
Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon 22711, Korea.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan 31151, Korea.
Cancers (Basel). 2021 Jul 16;13(14):3563. doi: 10.3390/cancers13143563.
The purpose of this study was to evaluate the prognostic significance of FDG uptake of bone marrow (BM SUV) and to investigate its role combined with radiomic features of primary tumors in improving the prediction of overall survival (OS) in patients with pancreatic cancer. We retrospectively enrolled 65 pancreatic cancer patients with staging FDG PET/CT. BM SUV and conventional imaging parameters of primary tumors including total lesion glycolysis (TLG) were measured. First-order and higher-order textural features of primary cancer were extracted using PET textural analysis. Associations of PET/CT parameters of bone marrow (BM) and primary cancer with OS were assessed. BM SUV as well as TLG and first-order entropy of pancreatic cancer were significant independent predictors of OS in multivariable analysis. A PET/CT scoring system based on the cumulative scores of these three independent predictors enabled patient stratification into three distinct prognostic groups. The scoring system yielded a good prognostic stratification based on subgroup analysis irrespective of tumor stage and treatment modality. BM SUV was an independent predictor of OS in pancreatic cancer patients. The PET/CT scoring system that integrated PET/CT parameters of primary tumors and BM can provide prognostic information in pancreatic cancer independent of tumor stage and treatment.
本研究的目的是评估骨髓氟代脱氧葡萄糖摄取（BM SUV）的预后意义，并研究其与原发性肿瘤的影像组学特征相结合在改善胰腺癌患者总生存期（OS）预测中的作用。我们回顾性纳入了65例接受分期氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）的胰腺癌患者。测量了BM SUV以及原发性肿瘤的传统影像参数，包括总病变糖酵解（TLG）。使用PET纹理分析提取原发性癌的一阶和高阶纹理特征。评估了骨髓（BM）和原发性癌的PET/CT参数与OS的相关性。在多变量分析中，BM SUV以及胰腺癌的TLG和一阶熵是OS的显著独立预测因素。基于这三个独立预测因素的累积分数的PET/CT评分系统能够将患者分层为三个不同的预后组。无论肿瘤分期和治疗方式如何，该评分系统基于亚组分析都产生了良好的预后分层。BM SUV是胰腺癌患者OS的独立预测因素。整合原发性肿瘤和BM的PET/CT参数的PET/CT评分系统可以在不考虑肿瘤分期和治疗的情况下为胰腺癌提供预后信息。
