Department of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, 49297, Korea.
Hell J Nucl Med. 2021 Sep-Dec;24(3):172-177. doi: 10.1967/s002449912400. Epub 2021 Dec 17.
The purpose of current study was to investigate the value of textural features used fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography ( F-FDG PET/CT) in predicting recurrence-free survival (RFS) and overall survival (OS) in patients with pancreatic cancer.
Seventy two patients with pancreatic cancer who underwent F-FDG PET/CT prior to curative surgical treatment were enrolled. Conventional parameters, such as maximum standardize uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were measured. Twenty-two textural features were extracted from PET images derived from first-order and 4 higher-order matrices: Grey level co-occurrence matrix (GLCM), neighborhood grey-level different matrix (NGLDM), grey-level run length matrix (GLRLM), and grey-level zone length matrix (GLZLM). Independent predictive factors for survival were determined using Cox proportional hazards regression models.
The SUVmax did not have prognostic values for RFS and OS. Median values of TLG and intratumoral heterogeneity parameter (kurtosis) were 63.95, and 3.15. High TLG and high kurtosis patients group showed shorter OS. Cox proportional hazards regression analysis revealed differentiation of the tumor, kurtosis and TLG were the significant predictive factors on OS. Besides, kurtosis presented no correlation with the conventional PET parameters, such as SUVmax, MTV and TLG.
This study suggests that intratumoral heterogeneity and volumetric parameter induced by F-FDG PET/CT could be significant prognostic surrogate markers in patients with pancreatic cancers.
本研究旨在探讨纹理特征在预测胰腺癌患者无复发生存（RFS）和总生存（OS）中的价值。
本研究共纳入 72 例接受氟-18-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）检查的胰腺癌患者。测量了最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和总肿瘤糖酵解（TLG）等常规参数。从一阶和 4 阶矩阵提取了 22 个纹理特征：灰度共生矩阵（GLCM）、邻域灰度差异矩阵（NGLDM）、灰度游程长度矩阵（GLRLM）和灰度区域长度矩阵（GLZLM）。采用 Cox 比例风险回归模型确定生存的独立预测因素。
SUVmax 对 RFS 和 OS 无预后价值。TLG 和肿瘤内异质性参数（峰度）的中位数分别为 63.95 和 3.15。高 TLG 和高峰度患者组的 OS 较短。Cox 比例风险回归分析显示，肿瘤分化、峰度和 TLG 是 OS 的显著预测因素。此外，峰度与 SUVmax、MTV 和 TLG 等常规 PET 参数无相关性。
本研究表明，F-FDG PET/CT 诱导的肿瘤内异质性和体积参数可能是胰腺癌患者的重要预后替代标志物。
