[18F]FDG-PET/CT 治疗前形态学和代谢综合参数对 NSCLC 患者无进展生存期（PFS）和总生存期（OS）的预后潜力。
Prognostic potential of integrated morphologic and metabolic parameters of pre-therapeutic [18F]FDG-PET/CT regarding progression-free survival (PFS) and overall survival (OS) in NSCLC-patients.
机构信息
Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Department of Nuclear Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
出版信息
PLoS One. 2024 Jul 29;19(7):e0307998. doi: 10.1371/journal.pone.0307998. eCollection 2024.
PURPOSE
This study aimed to evaluate the prognostic potential of pre-therapeutic [18F]FDG-PET/CT variables regarding prediction of progression-free survival (PFS) and overall survival (OS) in NSCLC-patients.
METHOD
NSCLC-patients who underwent pre-therapeutic [18F]FDG-PET/CT were retrospectively analyzed. The following imaging features were collected from the primary tumor: tumor size, tumor density, central necrosis, spicules and SUVmax. For standardization, an indexSUVmax was calculated (SUVmax primary tumor/SUVmax liver). Descriptive statistics and correlations of survival time analyses for PFS and OS were calculated using the Kaplan-Meier method and Cox regression including a hazard ratio (HR). A value of p < 0.05 was set as statistically significant. The 95%-confidence intervals (CI) were calculated. The median follow-up time was 63 (IQR 27-106) months.
RESULTS
This study included a total of 82 patients (25 women, 57 men; mean age: 66 ± 9 years). IndexSUVmax (PFS: HR = 1.0, CI: 1.0-1.1, p = 0.49; OS: HR = 1.0, CI: 0.9-1.2, p = 0.41), tumor size (PFS: HR = 1.0, CI: 0.9-1.0, p = 0.08; OS: HR = 1.0, CI: 0.9-1.0, p = 0.07), tumor density (PFS: HR = 0.9, CI: 0.6-1.4, p = 0.73; OS: HR = 0.3; CI: 0.1-1.1; p = 0.07), central necrosis (PFS: HR = 1.0, CI: 0.6-1.8, p = 0.98; OS: HR = 0.6, CI: 0.2-1.9, p = 0.40) and spicules (PFS: HR = 1.0, CI: 0.6-1.9, p = 0.91; OS: HR = 1.3, CI: 0.4-3.7, p = 0.65) did not significantly affect PFS and OS in the study population. An optimal threshold value for the indexSUVmax was determined by ROC analysis and Youden's index. There was no significant difference in PFS with an indexSUVmax-threshold of 3.8 (13 vs. 27 months; p = 0.45) and in OS with an indexSUVmax-threshold of 4.0 (113 vs. 106 months; p = 0.40).
CONCLUSIONS
SUVmax and morphologic parameters from pre-therapeutic [18F]FDG-PET/CT were not able to predict PFS and OS in NSCLC-patients.
目的
本研究旨在评估治疗前 [18F]FDG-PET/CT 变量在预测 NSCLC 患者无进展生存期（PFS）和总生存期（OS）方面的预后潜力。
方法
回顾性分析接受治疗前 [18F]FDG-PET/CT 的 NSCLC 患者。从原发肿瘤中收集以下影像学特征：肿瘤大小、肿瘤密度、中央坏死、刺突和 SUVmax。为了标准化，计算了指数 SUVmax（SUVmax 原发肿瘤/SUVmax 肝脏）。使用 Kaplan-Meier 方法和 Cox 回归（包括风险比（HR））计算生存时间分析的描述性统计和 PFS 和 OS 的相关性。p 值<0.05 被设定为具有统计学意义。中位随访时间为 63（IQR 27-106）个月。
结果
本研究共纳入 82 例患者（25 名女性，57 名男性；平均年龄：66±9 岁）。指数 SUVmax（PFS：HR=1.0，CI：1.0-1.1，p=0.49；OS：HR=1.0，CI：0.9-1.2，p=0.41）、肿瘤大小（PFS：HR=1.0，CI：0.9-1.0，p=0.08；OS：HR=1.0，CI：0.9-1.0，p=0.07）、肿瘤密度（PFS：HR=0.9，CI：0.6-1.4，p=0.73；OS：HR=0.3，CI：0.1-1.1，p=0.07）、中央坏死（PFS：HR=1.0，CI：0.6-1.8，p=0.98；OS：HR=0.6，CI：0.2-1.9，p=0.40）和刺突（PFS：HR=1.0，CI：0.6-1.9，p=0.91；OS：HR=1.3，CI：0.4-3.7，p=0.65）在研究人群中均未显著影响 PFS 和 OS。通过 ROC 分析和 Youden 指数确定了指数 SUVmax 的最佳截断值。指数 SUVmax 截断值为 3.8 时，PFS 无显著差异（13 个月 vs. 27 个月；p=0.45），指数 SUVmax 截断值为 4.0 时，OS 无显著差异（113 个月 vs. 106 个月；p=0.40）。
结论
治疗前 [18F]FDG-PET/CT 的 SUVmax 和形态学参数无法预测 NSCLC 患者的 PFS 和 OS。
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