PET/MRI 在子宫内膜癌中的应用：影像学生物标志物与疾病进展和总生存相关。
PET/MRI in Endometrial Cancer: Imaging Biomarkers are Associated with Disease Progression and Overall Survival.
机构信息
Department of Medical Imaging, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 100, Taiwan (I.-L.S., B.-B.C., Q.-Y.Z., T.T.- F.S.); Department of Radiology, College of Medicine, National Taiwan University, Taipei, Taiwan (I.-L.S., R.-F.Y., B.-B.C., Q.-Y.Z., M.-F.C., J.L.-Y.C., T.T.-F.S.).
Department of Radiology, College of Medicine, National Taiwan University, Taipei, Taiwan (I.-L.S., R.-F.Y., B.-B.C., Q.-Y.Z., M.-F.C., J.L.-Y.C., T.T.-F.S.); Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan (R.-F.Y., M.-F.C.).
出版信息
Acad Radiol. 2024 Mar;31(3):939-950. doi: 10.1016/j.acra.2023.08.012. Epub 2023 Sep 14.
RATIONALE AND OBJECTIVES
To evaluate the association between positron emission tomography (PET)/magnetic resonance imaging (MRI) biomarkers and survival outcomes in patients with endometrial cancer.
MATERIALS AND METHODS
Between April 2014 and April 2016, 88 patients with newly diagnosed endometrial cancer participated this prospective study and underwent [F] fluorodeoxyglucose PET/MRI. Sixty-nine patients with measurable tumors on PET/MRI were included in the image analysis. Imaging biomarkers included the minimum and mean apparent diffusion coefficients (ADC and ADC), maximum standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the primary tumors. The log-rank test and Cox proportional hazards model were used to assess the relationship between imaging biomarkers and survival.
RESULTS
After a median follow-up of 80 months, 15 (22%) patients had tumor progression and six (9%) patients died. The results of ADC, ADC, and SUV did not show a significant association with progression-free survival (PFS) and overall survival (OS). Significantly shorter PFS was noted in patients with primary tumors with higher MTV (P < 0.001) and TLG (P < 0.001). Significantly shorter OS was also noted in patients with primary tumors with higher MTV (P = 0.048) and TLG (P = 0.034). In the multivariate analysis, MTV was an independent predictor of PFS (hazard ratio = 10.84, P = 0.033).
CONCLUSION
PET/MRI biomarkers, particularly MTV and TLG, are associated with PFS and OS in patients with endometrial cancer. MTV was an independent predictor of PFS.
背景与目的
评估正电子发射断层扫描（PET）/磁共振成像（MRI）生物标志物与子宫内膜癌患者生存结局的相关性。
材料与方法
2014 年 4 月至 2016 年 4 月，88 例新诊断为子宫内膜癌的患者参与了这项前瞻性研究，并接受了[F]氟脱氧葡萄糖 PET/MRI 检查。69 例 PET/MRI 可测量肿瘤的患者纳入了图像分析。成像生物标志物包括原发肿瘤的最小和平均表观扩散系数（ADC 和 ADC）、最大标准化摄取值（SUV）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。采用对数秩检验和 Cox 比例风险模型评估影像学标志物与生存的关系。
结果
中位随访 80 个月后，15 例（22%）患者肿瘤进展，6 例（9%）患者死亡。ADC、ADC 和 SUV 结果与无进展生存期（PFS）和总生存期（OS）均无显著相关性。原发肿瘤 MTV 和 TLG 较高的患者 PFS 显著缩短（P<0.001）。原发肿瘤 MTV 和 TLG 较高的患者 OS 也显著缩短（P=0.048 和 P=0.034）。多变量分析显示，MTV 是 PFS 的独立预测因子（风险比=10.84，P=0.033）。
结论
PET/MRI 生物标志物，尤其是 MTV 和 TLG，与子宫内膜癌患者的 PFS 和 OS 相关。MTV 是 PFS 的独立预测因子。
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