动态C-蛋氨酸PET-CT：疑似胶质瘤复发患者疾病进展和生存的预后因素
Dynamic C-Methionine PET-CT: Prognostic Factors for Disease Progression and Survival in Patients with Suspected Glioma Recurrence.
作者信息
Mattoli Maria Vittoria, Trevisi Gianluca, Scolozzi Valentina, Capotosti Amedeo, Cocciolillo Fabrizio, Marini Irene, Mare Valerio, Indovina Luca, Caulo Massimo, Saponiero Antonella, Balducci Mario, Taralli Silvia, Calcagni Maria Lucia
机构信息
Department of Neurosciences, Imaging and Clinical Sciences, University "G. d'Annunzio" of Chieti, 66100 Chieti, Italy.
Neurosurgical Unit, Presidio Ospedaliero Santo Spirito, 65124 Pescara, Italy.
出版信息
Cancers (Basel). 2021 Sep 24;13(19):4777. doi: 10.3390/cancers13194777.
PURPOSE
The prognostic evaluation of glioma recurrence patients is important in the therapeutic management. We investigated the prognostic value of C-methionine PET-CT (MET-PET) dynamic and semiquantitative parameters in patients with suspected glioma recurrence.
METHODS
Sixty-seven consecutive patients who underwent MET-PET for suspected glioma recurrence at MR were retrospectively included. Twenty-one patients underwent static MET-PET; 46/67 underwent dynamic MET-PET. In all patients, SUVmax, SUVmean and tumour-to-background ratio (T/B) were calculated. From dynamic acquisition, the shape and slope of time-activity curves, time-to-peak and its SUVmax (SUVmax) were extrapolated. The prognostic value of PET parameters on progression-free (PFS) and overall survival (OS) was evaluated using Kaplan-Meier survival estimates and Cox regression.
RESULTS
The overall median follow-up was 19 months from MET-PET. Recurrence patients (38/67) had higher SUVmax ( = 0.001), SUVmean ( = 0.002) and T/B ( < 0.001); deceased patients (16/67) showed higher SUVmax ( = 0.03), SUVmean ( = 0.03) and T/B ( = 0.006). All static parameters were associated with PFS (all < 0.001); T/B was associated with OS ( = 0.031). Regarding kinetic analyses, recurrence (27/46) and deceased (14/46) patients had higher SUVmax ( = 0.02, = 0.01, respectively). SUVmax was the only dynamic parameter associated with PFS ( = 0.02) and OS ( = 0.006). At univariate analysis, SUVmax, SUVmean, T/B and SUVmax were predictive for PFS (all < 0.05); SUVmax was predictive for OS ( = 0.02). At multivariate analysis, SUVmax remained significant for PFS ( = 0.03).
CONCLUSION
Semiquantitative parameters and SUVmax were associated with clinical outcomes in patients with suspected glioma recurrence. Dynamic PET-CT acquisition, with static and kinetic parameters, can be a valuable non-invasive prognostic marker, identifying patients with worse prognosis who require personalised therapy.
目的
胶质瘤复发患者的预后评估在治疗管理中至关重要。我们研究了¹¹C-蛋氨酸PET-CT（MET-PET）动态和半定量参数在疑似胶质瘤复发患者中的预后价值。
方法
回顾性纳入67例因疑似胶质瘤复发在磁共振成像（MR）后接受MET-PET检查的连续患者。21例患者接受了静态MET-PET检查；46/67例接受了动态MET-PET检查。在所有患者中，计算了最大标准摄取值（SUVmax）、平均标准摄取值（SUVmean）和肿瘤与本底比值（T/B）。从动态采集数据中，推断出时间-活性曲线的形状和斜率、达峰时间及其SUVmax（SUVmax）。使用Kaplan-Meier生存估计和Cox回归评估PET参数对无进展生存期（PFS）和总生存期（OS）的预后价值。
结果
从MET-PET检查开始的总体中位随访时间为19个月。复发患者（38/67）的SUVmax（P = 0.001）、SUVmean（P = 0.002）和T/B（P < 0.001）较高；死亡患者（16/67）的SUVmax（P = 0.03）、SUVmean（P = 0.03）和T/B（P = 0.006）较高。所有静态参数均与PFS相关（均P < 0.001）；T/B与OS相关（P = 0.031）。关于动力学分析，复发患者（27/46）和死亡患者（14/46）的SUVmax较高（分别为P = 0.02、P = 0.01）。SUVmax是唯一与PFS（P = 0.02）和OS（P = 0.006）相关的动态参数。在单因素分析中，SUVmax、SUVmean、T/B和SUVmax对PFS具有预测性（均P < 0.05）；SUVmax对OS具有预测性（P = 0.02）。在多因素分析中，SUVmax对PFS仍具有显著性（P = 0.03）。
结论
半定量参数和SUVmax与疑似胶质瘤复发患者的临床结局相关。动态PET-CT采集，结合静态和动力学参数，可成为一种有价值的非侵入性预后标志物，识别预后较差、需要个性化治疗的患者。
Zotero 插件