PET Center, Department of Nuclear Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University.
Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University.
Nucl Med Commun. 2023 Aug 1;44(8):719-725. doi: 10.1097/MNM.0000000000001713. Epub 2023 Jun 12.
This study aimed to investigate the association between 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/computed tomography (CT) and clinicopathological characteristics and sarcopenia in patients with pancreatic cancer and to determine their prognostic roles.
Clinicopathological factors and 18 F-FDG PET/CT metabolic parameters of maximum standard uptake value, metabolic tumor volume, and total lesion glycolysis of the primary tumor (SUVmax_P, MTV_P, and TLG_P) and of whole-body lesions (MTV_T and TLG_T) were retrospectively reviewed in 113 pretreatment patients with pancreatic cancer. Sarcopenia was defined based on skeletal muscle index (SMI) calculated at the third lumbar vertebra (L3), and SUVmax of the psoas major muscle (SUVmax_M) was measured at L3 as well. The primary endpoint used was the overall survival (OS).
Among 113 patients, 49 patients (43.4%) were diagnosed with sarcopenia. Compared with nonsarcopenia, sarcopenia more frequently occurred in the older population ( P = 0.027), males ( P = 0.014), and lower BMI ( P < 0.001), and displayed lower SUVmax_M ( P = 0.011). Age, sex, BMI, and SUVmax_M were independently predictive of sarcopenia. Multivariate Cox regression analysis revealed that tumor stage ( P = 0.010) and TLG_T ( P < 0.001) were independently predictive of OS.
Sarcopenia increased with declining SUVmax_M in pancreatic cancer. Compared with SMI, SUVmax_M offers a more straightforward prediction of sarcopenia, thus a promising measurement to be incorporated into the diagnostic algorithm. Tumor stage and TLG_T, but not sarcopenia, were independent prognostic factors of pancreatic cancer.
本研究旨在探讨 18 F-氟脱氧葡萄糖(18 F-FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)与胰腺癌患者临床病理特征及肌肉减少症之间的关系,并确定其预后作用。
回顾性分析 113 例术前胰腺癌患者的临床病理因素及 18 F-FDG PET/CT 最大标准摄取值、代谢肿瘤体积和肿瘤总糖酵解(SUVmax_P、MTV_P 和 TLG_P)及全身病变的代谢肿瘤体积和肿瘤总糖酵解(MTV_T 和 TLG_T)的代谢参数。采用第三腰椎(L3)处骨骼肌指数(SMI)定义肌肉减少症,在 L3 处测量腰大肌 SUVmax(SUVmax_M)。主要终点是总生存期(OS)。
在 113 例患者中,49 例(43.4%)被诊断为肌肉减少症。与非肌肉减少症相比,肌肉减少症更常发生于老年人群(P=0.027)、男性(P=0.014)和较低 BMI 人群(P<0.001),且 SUVmax_M 较低(P=0.011)。年龄、性别、BMI 和 SUVmax_M 是肌肉减少症的独立预测因素。多因素 Cox 回归分析显示,肿瘤分期(P=0.010)和 TLG_T(P<0.001)是 OS 的独立预测因素。
胰腺癌患者的肌肉减少症与 SUVmax_M 呈负相关。与 SMI 相比,SUVmax_M 对肌肉减少症的预测更为直接,因此有望成为纳入诊断算法的一项有前途的指标。肿瘤分期和 TLG_T 是胰腺癌的独立预后因素,而不是肌肉减少症。