Division of Thoracic Surgery, Chang Gung Memorial Hospital-Linko, Chang Gung University, Taoyuan, 333423, Taiwan.
Department of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, 333423, Taiwan.
Cancer Imaging. 2023 Nov 6;23(1):109. doi: 10.1186/s40644-023-00630-2.
To investigate the value of [18F]FDG-PET/MRI in predicting treatment response and survival in patients with primary M0 esophageal squamous cell carcinoma.
Patients with esophageal squamous cell carcinoma received [18F]FDG-PET/MRI at baseline and during neoadjuvant or definitive chemoradiotherapy. The treatment response was classified according to the Response Evaluation Criteria for Solid Tumors 1.1. We used Kaplan-Meier and Cox regression analyses to assess the association between PET/MRI parameters and overall survival (OS) or progression-free survival (PFS).
We included 40 M0 patients in the final analysis. The volume transfer constant (K) from baseline PET/MRI (area under the curve (AUC) = 0.688, P = 0.034) and total lesion glycolysis (TLG) from baseline PET/MRI (AUC = 0.723, P = 0.006) or interim PET/MRI (AUC = 0.853, P < 0.001) showed acceptable AUC for predicting treatment response. The TLG from interim PET/MRI (interim TLG, P < 0.001) and extracellular volume fraction (Ve) on interim PET/MRI (interim Ve, P = 0.001) were identified as independent prognostic factors for OS. Baseline Ve (P = 0.044) and interim TLG (P = 0.004) were significant predictors of PFS. The c-indices of the prognostic models combining interim TLG with Ve for predicting OS, and baseline Ve and interim TLG for predicting PFS were 0.784 and 0.699, respectively. These values were significantly higher than the corresponding c-indices of the TNM staging system (P = 0.002 and P = 0.047, respectively).
Combining the baseline and interim [18F]FDG-PET/MRI qualitative imaging parameters aids in predicting the prognosis of patients with M0 esophageal squamous cell carcinoma.
The study was registered at Clinicaltrials.gov (identifier: NCT05855291 and NCT05855278).
探讨 [18F]FDG-PET/MRI 在预测原发性 M0 食管鳞癌患者治疗反应和生存中的价值。
食管鳞癌患者在基线时和新辅助或根治性放化疗期间接受 [18F]FDG-PET/MRI。根据实体瘤反应评估标准 1.1 对治疗反应进行分类。我们使用 Kaplan-Meier 和 Cox 回归分析评估 PET/MRI 参数与总生存期（OS）或无进展生存期（PFS）之间的关系。
最终纳入 40 例 M0 患者进行分析。基线 PET/MRI 的容积转移常数（K）（曲线下面积（AUC）=0.688，P=0.034）和基线 PET/MRI 的总病变糖酵解（TLG）（AUC=0.723，P=0.006）或中期 PET/MRI（AUC=0.853，P<0.001）的 TLG 对预测治疗反应具有可接受的 AUC。中期 PET/MRI 的 TLG（中期 TLG，P<0.001）和中期 PET/MRI 的细胞外容积分数（Ve）（中期 Ve，P=0.001）被确定为 OS 的独立预后因素。基线 Ve（P=0.044）和中期 TLG（P=0.004）是 PFS 的显著预测因素。结合中期 TLG 和 Ve 的预后模型预测 OS 的 C 指数为 0.784，结合基线 Ve 和中期 TLG 预测 PFS 的 C 指数为 0.699，均显著高于 TNM 分期系统的相应 C 指数（P=0.002 和 P=0.047）。
结合基线和中期 [18F]FDG-PET/MRI 定性成像参数有助于预测 M0 食管鳞癌患者的预后。
该研究在 Clinicaltrials.gov 注册（标识符：NCT05855291 和 NCT05855278）。
