动态F-FDG PET/CT在预测局部晚期乳腺癌患者新辅助化疗疗效中的价值：一项前瞻性研究
Value of Dynamic F-FDG PET/CT in Predicting the Success of Neoadjuvant Chemotherapy in Patients with Locally Advanced Breast Cancer: A Prospective Study.
作者信息
Kupik Osman, Tuncel Murat, Özgen Kıratlı Pınar, Akpınar Meltem Gülsün, Altundağ Kadri, Başaran Demirkazık Figen, Erbaş Belkıs
机构信息
Muğla Training and Research Hospital, Clinic of Nuclear Medicine, Muğla, Turkey.
Hacettepe University Faculty of Medicine, Department of Nuclear Medicine, Ankara Turkey.
出版信息
Mol Imaging Radionucl Ther. 2023 Jun 20;32(2):94-102. doi: 10.4274/mirt.galenos.2022.97658.
OBJECTIVES
This prospective study was planned to compare the predictive value of dynamic F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in locally advanced breast cancer patients (LABC) receiving neoadjuvant chemotherapy (NAC).
METHODS
Twenty seven patients with LABC [median age: 47, (26-66)] underwent a dynamic F-FDG PET study at baseline, and after 2-3 cycles of (NAC) were included (interim). Maximum standardized uptake value (SUV) values and SUV ratios for the 2, 5, 10, and 30 minutes and dynamic curve slope (SL) values and SL ratios were measured using F-FDG dynamic data. In addition, the values of SUV (2minSUVmean), SULpeak (2minSULpeak), metabolic volume (2minVol), and total lesion glycolysis (2minTLG) were measured for the first 2 min. Percent changes between baseline and interim studies were calculated and compared with the pathological results as the pathological complete response (PCR) or the pathological non-complete response (non-PCR). Receiver operating characteristic curves were obtained to calculate the area under the curve to predict PCR. Optimal threshold values were calculated to discriminate between PCR and non-PCR groups.
RESULTS
Baseline study SUV 30 (p=0.044), SUV 30/2 (p=0.041), SUV 30/5 (p=0.049), SUV 30/10 (p=0.021), SL 30/2 (p=0.029) and SL 30/5 (p=0.027) values were statistically significant different between PCR and non-PCR groups. The percentage changes of 2minVol between PCR and non-PCR groups were statistically significant. For the threshold value of -67.6% change in 2minVol, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 87.2%, 77.8%, 63.6%, 93.3%, and 80.7%, respectively (area under the curve: 0.826, p=0.009).
CONCLUSION
Semiquantitative parameters for dynamic F-FDG PET can predict PCR. % changes in 2minVol can identify non-responding patients better than other parameters.
目的
本前瞻性研究旨在比较动态F-氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在接受新辅助化疗（NAC）的局部晚期乳腺癌患者（LABC）中的预测价值。
方法
27例LABC患者[中位年龄：47岁，（26 - 66岁）]在基线时接受了动态F-FDG PET研究，并在接受2 - 3个周期的（NAC）后纳入研究（中期）。使用F-FDG动态数据测量2、5、10和30分钟时的最大标准化摄取值（SUV）、SUV比值以及动态曲线斜率（SL）值和SL比值。此外，测量前2分钟的SUV（2minSUVmean）、SUL峰值（2minSULpeak）、代谢体积（2minVol）和总病变糖酵解（2minTLG）值。计算基线和中期研究之间的百分比变化，并与病理结果进行比较，将其作为病理完全缓解（PCR）或病理非完全缓解（非PCR）。获得受试者操作特征曲线以计算预测PCR的曲线下面积。计算最佳阈值以区分PCR组和非PCR组。
结果
PCR组和非PCR组之间基线研究的SUV 30（p = 0.044）、SUV 30/2（p = 0.041）、SUV 30/5（p = 0.049）、SUV 30/10（p = 0.021）、SL 30/2（p = 0.029）和SL 30/5（p = 0.027）值在统计学上有显著差异。PCR组和非PCR组之间2minVol的百分比变化在统计学上有显著差异。对于2minVol变化-67.6%的阈值，敏感性、特异性、阳性预测值、阴性预测值和准确性分别为87.2%、77.8%、63.6%、93.3%和80.7%（曲线下面积：0.826，p = 0.009）。
结论
动态F-FDG PET的半定量参数可预测PCR。2minVol的百分比变化比其他参数能更好地识别无反应患者。
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