定义用于测量 68Ga-DOTATATE 正电子发射断层扫描/计算机断层扫描中生长抑素受体表达肿瘤体积的最佳分割方法，以预测胃肠胰神经内分泌肿瘤患者的预后。
Defining the optimal segmentation method for measuring somatostatin receptor expressing tumor volume on 68 Ga-DOTATATE positron emission tomography/computed tomography to predict prognosis in patients with gastroenteropancreatic neuroendocrine tumors.
机构信息
Department of Nuclear Medicine, University of Health Sciences, Kartal Dr. Lutfi Kirdar City Hospital, .
Department of Nuclear Medicine, Marmara University Pendik Training and Research Hospital and .
出版信息
Nucl Med Commun. 2024 Aug 1;45(8):736-744. doi: 10.1097/MNM.0000000000001861. Epub 2024 May 15.
OBJECTIVE
We aimed to compare different segmentation methods used to calculate prognostically valuable volumetric parameters, somatostatin receptor expressing tumor volume (SRETV), and total lesion somatostatin receptor expression (TLSRE), measured by 68 Ga-DOTATATE PET/CT and to find the optimal segmentation method to predict prognosis.
PATIENTS AND METHODS
Images of 34 patients diagnosed with gastroenteropancreatic neuroendocrine tumor (GEPNET) who underwent 68 Ga-DOTATATE PET/CT imaging were reanalyzed. Four different threshold-based methods (fixed relative threshold method, normal liver background threshold method, fixed absolute standardized uptake value (SUV) threshold method, and adaptive threshold method) were used to calculate SRETV and TLSRE values. SRETV of all lesions of a patient was summarized as whole body SRETV (WB-SRETV) and TLSRE of all lesions of a patient was computed as whole body TLSRE (WB-TLSRE).
RESULTS
WB-SRETVs calculated with all segmentation methods were statistically significantly associated with progression-free survival except WB-SRETV at which was calculated using adaptive threshold method. The fixed relative threshold methods calculated by using 45% (WB-SRETV 45% ) and 60% (WB-SRETV 60% ) of the SUV value as threshold respectively, were found to have statistically significant highest prognostic value (C-index = 0.704, CI = 0.622-0.786, P = 0.007). Among WB-TLSRE parameters, WB-TLSRE 35% , WB-TLSRE 40% , and WB-TLSRE 50% had the highest prognostic value (C-index = 0.689, CI = 0.604-0.774, P = 0.008).
CONCLUSION
The fixed relative threshold method was found to be the most effective and easily applicable method to measure SRETV on pretreatment 68 Ga-DOTATATE PET/CT to predict prognosis in GEPNET patients. WB-SRETV 45% (cutoff value of 11.8 cm 3 ) and WB-SRETV 60% (cutoff value of 6.3 cm 3 ) were found to be the strongest predictors of prognosis in GEPNET patients.
目的
我们旨在比较通过 68Ga-DOTATATE PET/CT 测量的用于计算预后有价值的容积参数、生长抑素受体表达肿瘤体积 (SRETV) 和总病变生长抑素受体表达 (TLSRE) 的不同分割方法，并找到预测预后的最佳分割方法。
患者和方法
对 34 名经 68Ga-DOTATATE PET/CT 成像诊断为胃肠胰腺神经内分泌肿瘤 (GEPNET) 的患者的图像进行了重新分析。使用了四种不同的基于阈值的方法（固定相对阈值法、正常肝脏背景阈值法、固定标准化摄取值 (SUV) 阈值法和自适应阈值法）来计算 SRETV 和 TLSRE 值。每位患者所有病灶的 SRETV 汇总为全身 SRETV（WB-SRETV），每位患者所有病灶的 TLSRE 计算为全身 TLSRE（WB-TLSRE）。
结果
除使用自适应阈值法计算的 WB-SRETV 外，所有分割方法计算的 WB-SRETV 均与无进展生存期显著相关。使用 SUV 值的 45%（WB-SRETV 45%）和 60%（WB-SRETV 60%）作为阈值的固定相对阈值方法被发现具有统计学上显著的最高预后价值（C 指数=0.704，CI=0.622-0.786，P=0.007）。在 WB-TLSRE 参数中，WB-TLSRE 35%、WB-TLSRE 40%和 WB-TLSRE 50%具有最高的预后价值（C 指数=0.689，CI=0.604-0.774，P=0.008）。
结论
固定相对阈值法被发现是在预处理 68Ga-DOTATATE PET/CT 上测量 SRETV 以预测 GEPNET 患者预后的最有效和易于应用的方法。WB-SRETV 45%（截断值为 11.8cm3）和 WB-SRETV 60%（截断值为 6.3cm3）被发现是 GEPNET 患者最强的预后预测指标。
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