Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Department of Nuclear Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, 26426, Republic of Korea.
Sci Rep. 2021 Dec 6;11(1):23486. doi: 10.1038/s41598-021-03023-2.
We evaluated the predictive value of F-fluorodeoxyglucose (FDG) uptake on positron emission tomography/CT (PET/CT) for extended pathological T (pT) stages (≥ pT3a) in Renal cell carcinoma (RCC) patients at staging. Thirty-eight RCC patients who underwent F-FDG PET/CT at staging, followed by radical nephrectomy between September 2016 and September 2018, were included in this prospective study. Patients were classified into two groups (limited pT stage: stage T1/2, n = 17; extended pT stage: T3/4, n = 21). Univariate and multivariate logistic regression analyses were performed to identify clinicopathological and metabolic variables to predict extended pT stages. F-FDG metabolic parameters were compared in relation to International Society of Urological Pathology (ISUP) grade and lymphovascular invasion (LVI). In univariate analysis, maximum standardised uptake value, metabolic tumour volume (MTV), and ISUP grade were significant. In multivariate analysis, MTV was the only significant factor of extended pT stages. With a cut-off MTV of 21.2, an area under the curve was 0.944, which was higher than 0.824 for clinical T stages (p = 0.037). In addition, high MTV, but not tumour size, was significantly correlated with aggressive pathologic features (ISUP grade and LVI). High glycolytic tumour volume on F-FDG PET/CT in RCC patients at staging is predictive of extended pT stages which could aid decision-making regarding the best type of surgery.
我们评估了氟代脱氧葡萄糖（FDG）摄取在正电子发射断层扫描/计算机断层扫描（PET/CT）在肾癌（RCC）患者分期时预测扩展病理 T（pT）分期（≥pT3a）的价值。本前瞻性研究纳入了 2016 年 9 月至 2018 年 9 月期间接受 F-FDG PET/CT 分期后接受根治性肾切除术的 38 例 RCC 患者。患者分为两组（局限性 pT 期：T1/2 期，n=17；扩展 pT 期：T3/4 期，n=21）。进行单变量和多变量逻辑回归分析，以确定预测扩展 pT 分期的临床病理和代谢变量。比较 F-FDG 代谢参数与国际泌尿病理学会（ISUP）分级和血管淋巴管侵犯（LVI）的关系。在单变量分析中，最大标准化摄取值、代谢肿瘤体积（MTV）和 ISUP 分级具有统计学意义。在多变量分析中，MTV 是扩展 pT 分期的唯一显著因素。以 MTV 为 21.2 的截断值，曲线下面积为 0.944，高于临床 T 分期的 0.824（p=0.037）。此外，高 MTV 但不是肿瘤大小与侵袭性病理特征（ISUP 分级和 LVI）显著相关。在 RCC 患者分期时 F-FDG PET/CT 上高糖酵解肿瘤体积可预测扩展的 pT 分期，有助于决策最佳手术类型。
