Pellegrino Sara, Fonti Rosa, Hakkak Moghadam Torbati Armin, Bologna Roberto, Morra Rocco, Damiano Vincenzo, Matano Elide, De Placido Sabino, Del Vecchio Silvana
Department of Advanced Biomedical Sciences, University of Naples "Federico II", 80131 Naples, Italy.
Department of Clinical Medicine and Surgery, University of Naples "Federico II", 80131 Naples, Italy.
Diagnostics (Basel). 2023 Jul 22;13(14):2448. doi: 10.3390/diagnostics13142448.
We investigated the role of Coefficient of Variation (CoV), a first-order texture parameter derived from F-FDG PET/CT, in the prognosis of Non-Small Cell Lung Cancer (NSCLC) patients. Eighty-four patients with advanced NSCLC who underwent F-FDG PET/CT before therapy were retrospectively studied. SUVmax, SUVmean, CoV, total Metabolic Tumor Volume (MTV) and whole-body Total Lesion Glycolysis (TLG) were determined by an automated contouring program (SUV threshold at 2.5). We analyzed 194 lesions: primary tumors ( = 84), regional ( = 48) and non-regional ( = 17) lymph nodes and metastases in liver ( = 9), bone ( = 23) and other sites ( = 13); average CoVs were 0.36 ± 0.13, 0.36 ± 0.14, 0.42 ± 0.18, 0.30 ± 0.14, 0.37 ± 0.17, 0.34 ± 0.13, respectively. No significant differences were found between the CoV values among the different lesion categories. Survival analysis included age, gender, histology, stage, MTV, TLG and imaging parameters derived from primary tumors. At univariate analysis, CoV ( = 0.0184), MTV ( = 0.0050), TLG ( = 0.0108) and stage ( = 0.0041) predicted Overall Survival (OS). At multivariate analysis, age, CoV, MTV and stage were retained in the model ( = 0.0001). Patients with CoV > 0.38 had significantly better OS than those with CoV ≤ 0.38 ( = 0.0143). Patients with MTV ≤ 89.5 mL had higher OS than those with MTV > 89.5 mL ( = 0.0063). Combining CoV and MTV, patients with CoV ≤ 0.38 and MTV > 89.5 mL had the worst prognosis. CoV, by reflecting the heterogeneity of glycolytic phenotype, can predict clinical outcomes in NSCLC patients.
我们研究了变异系数（CoV）这一从F-FDG PET/CT得出的一阶纹理参数在非小细胞肺癌（NSCLC）患者预后中的作用。对84例在治疗前接受F-FDG PET/CT检查的晚期NSCLC患者进行了回顾性研究。通过自动轮廓程序（SUV阈值设定为2.5）确定SUVmax、SUVmean、CoV、总代谢肿瘤体积（MTV）和全身总病变糖酵解（TLG）。我们分析了194个病灶：原发性肿瘤（n = 84）、区域淋巴结（n = 48）和非区域淋巴结（n = 17）以及肝脏转移灶（n = 9）、骨转移灶（n = 23）和其他部位转移灶（n = 13）；平均CoV分别为0.36±0.13、0.36±0.14、0.42±0.18、0.30±0.14、0.37±0.17、0.34±0.13。不同病灶类别之间的CoV值未发现显著差异。生存分析纳入了年龄、性别、组织学类型、分期、MTV、TLG以及源自原发性肿瘤的影像参数。单因素分析时，CoV（P = 0.0184）、MTV（P = 0.0050）、TLG（P = 0.0108）和分期（P = 0.0041）可预测总生存期（OS）。多因素分析时，年龄、CoV、MTV和分期被纳入模型（P = 0.0001）。CoV>0.38的患者OS显著优于CoV≤0.38的患者（P = 0.0143）。MTV≤89.5 mL的患者OS高于MTV>89.5 mL的患者（P = 0.0063）。联合CoV和MTV，CoV≤0.38且MTV>89.5 mL的患者预后最差。CoV通过反映糖酵解表型的异质性，可预测NSCLC患者的临床结局。
