Bezzi Carolina, Monaco Lavinia, Ghezzo Samuele, Mathoux Gregory, Bergamini Alice, Zambella Enrica, Fallanca Federico, Samanes Gajate Ana Maria, Presotto Luca, Sabetta Giulia, Mangili Giorgia, Cioffi Raffaella, Bettinardi Valentino, Gianolli Luigi, Mapelli Paola, Picchio Maria
University of Milano-Bicocca.
From the Vita-Salute San Raffaele University.
Clin Nucl Med. 2022 Jun 1;47(6):525-531. doi: 10.1097/RLU.0000000000004135. Epub 2022 Mar 30.
The aim of this study was to investigate the role of 18F-FDG PET/CT in predicting pathological prognostic factors, including tumor type and International Federation of Gynecology and Obstetrics (FIGO) score, in gestational trophoblastic disease (GTD).
Retrospective monocentric study including 24 consecutive patients who underwent to 18F-FDG PET/CT from May 2005 to March 2021 for GTD staging purpose. The following semiquantitative PET parameters were measured from the primary tumor and used for the analysis: maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume (MTV) and total lesion glycolisis (TLG). Statistical analysis included Spearman correlation coefficient to evaluate the correlations between imaging parameters and tumor type (nonmolar trophoblastic vs postmolar trophoblastic tumors) and risk groups (high vs low, defined according to the FIGO score), whereas area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to assess the predictive value of the PET parameters. Mann-Whitney U test was used to further describe the parameter's potential in differentiating the populations.
SUVmax and SUVmean resulted fair (AUC, 0.783; 95% confidence interval [CI], 0.56-0.95) and good (AUC, 0.811; 95% CI, 0.59-0.97) predictors of tumor type, respectively, showing a low (ρ = 0.489, adjusted P = 0.030) and moderate (ρ = 0.538, adjusted P = 0.027) correlation. According to FIGO score, TLG was instead a fair predictor (AUC, 0.770; 95% CI, 0.50-0.99) for patient risk stratification.
18F-FDG PET parameters have a role in predicting GTD pathological prognostic factors, with SUVmax and SUVmean being predictive for tumor type and TLG for risk stratification.
本研究旨在探讨18F-FDG PET/CT在预测妊娠滋养细胞疾病（GTD）的病理预后因素（包括肿瘤类型和国际妇产科联盟（FIGO）评分）中的作用。
回顾性单中心研究，纳入2005年5月至2021年3月期间连续24例因GTD分期目的接受18F-FDG PET/CT检查的患者。从原发肿瘤测量以下半定量PET参数并用于分析：最大标准化摄取值（SUVmax）、SUV均值、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。统计分析包括Spearman相关系数，以评估影像参数与肿瘤类型（非葡萄胎滋养细胞肿瘤与葡萄胎后滋养细胞肿瘤）和风险组（高风险与低风险，根据FIGO评分定义）之间的相关性，而受试者操作特征（ROC）曲线的曲线下面积（AUC）用于评估PET参数的预测价值。Mann-Whitney U检验用于进一步描述参数在区分人群方面的潜力。
SUVmax和SUV均值分别是肿瘤类型的中等（AUC，0.783；95%置信区间[CI]，0.56 - 0.95）和良好（AUC，0.811；95% CI，0.59 - 0.97）预测指标，显示出低（ρ = 0.489，校正P = 0.030）和中等（ρ = 0.538，校正P = 0.027）相关性。根据FIGO评分，TLG是患者风险分层的中等预测指标（AUC，0.770；95% CI，0.50 - 0.99）。
18F-FDG PET参数在预测GTD病理预后因素中具有作用，SUVmax和SUV均值可预测肿瘤类型，TLG可用于风险分层。
