18 F-FDG PET/CT 代谢参数与肝癌患者肝移植前微血管侵犯的相关性。
Correlation between 18 F-FDG PET/CT metabolic parameters and microvascular invasion before liver transplantation in patients with hepatocellular carcinoma.
机构信息
Department of Nuclear Medicine and Radiology, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University.
Department of Radiology, The Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital.
出版信息
Nucl Med Commun. 2024 Dec 1;45(12):1033-1038. doi: 10.1097/MNM.0000000000001897. Epub 2024 Sep 13.
BACKGROUND
Microvascular infiltration (MVI) before liver transplantation (LT) in patients with hepatocellular carcinoma (HCC) is associated with postoperative tumor recurrence and survival. MVI is mainly assessed by pathological analysis of tissue samples, which is invasive and heterogeneous. PET/computed tomography (PET/CT) with 18 F-labeled fluorodeoxyglucose ( 18 F-FDG) as a tracer has been widely used in the examination of malignant tumors. This study investigated the association between 18 F-FDG PET/CT metabolic parameters and MVI before LT in HCC patients.
METHODS
About 124 HCC patients who had 18 F-FDG PET/CT examination before LT were included. The patients' clinicopathological features and 18 F-FDG PET/CT metabolic parameters were recorded. Correlations between clinicopathological features, 18 F-FDG PET/CT metabolic parameters, and MVI were analyzed. ROC curve was used to determine the optimal diagnostic cutoff value, area under the curve (AUC), sensitivity, and specificity for predictors of MVI.
RESULT
In total 72 (58.06%) patients were detected with MVI among the 124 HCC patients. Univariate analysis showed that tumor size ( P = 0.001), T stage ( P < 0.001), maximum standardized uptake value (SUV max ) ( P < 0.001), minimum standardized uptake value (SUV min ) ( P = 0.031), mean standardized uptake value (SUV mean ) ( P = 0.001), peak standardized uptake value (SUV peak ) ( P = 0.001), tumor-to-liver ratio (SUV ratio ) ( P = 0.010), total lesion glycolysis (TLG) ( P = 0.006), metabolic tumor volume (MTV) ( P = 0.011) and MVI were significantly different. Multivariate logistic regression showed that tumor size ( P = 0.018), T stage ( P = 0.017), TLG ( P = 0.023), and MTV ( P = 0.015) were independent predictors of MVI. In the receiver operating characteristic curve, TLG predicted MVI with an AUC value of 0.645. MTV predicted MVI with an AUC value of 0.635. Patients with tumor size ≥5 cm, T3-4, TLG > 400.67, and MTV > 80.58 had a higher incidence of MVI.
CONCLUSION
18 F-FDG PET/CT metabolic parameters correlate with MVI and may be used as a noninvasive technique to predict MVI before LT in HCC patients.
背景
肝癌（HCC）患者肝移植（LT）前的微血管浸润（MVI）与术后肿瘤复发和生存有关。MVI 主要通过组织样本的病理分析来评估，这种方法具有侵袭性且存在异质性。正电子发射断层扫描/计算机断层扫描（PET/CT）结合 18 氟标记的氟脱氧葡萄糖（ 18 F-FDG）作为示踪剂已广泛应用于恶性肿瘤的检查。本研究探讨了 HCC 患者 LT 前 18 F-FDG PET/CT 代谢参数与 MVI 的相关性。
方法
纳入了 124 例接受 18 F-FDG PET/CT 检查的 HCC 患者。记录了患者的临床病理特征和 18 F-FDG PET/CT 代谢参数。分析了临床病理特征、18 F-FDG PET/CT 代谢参数与 MVI 之间的相关性。采用 ROC 曲线确定预测 MVI 的最佳截断值、曲线下面积（AUC）、灵敏度和特异性。
结果
在 124 例 HCC 患者中，共有 72 例（58.06%）患者检测到 MVI。单因素分析显示，肿瘤大小（ P = 0.001）、T 分期（ P < 0.001）、最大标准化摄取值（SUV max ）（ P < 0.001）、最小标准化摄取值（SUV min ）（ P = 0.031）、平均标准化摄取值（SUV mean ）（ P = 0.001）、峰值标准化摄取值（SUV peak ）（ P = 0.001）、肿瘤与肝脏的比值（SUV ratio ）（ P = 0.010）、总病变糖酵解（TLG）（ P = 0.006）、肿瘤代谢体积（MTV）（ P = 0.011）和 MVI 之间存在显著差异。多因素 logistic 回归显示，肿瘤大小（ P = 0.018）、T 分期（ P = 0.017）、TLG（ P = 0.023）和 MTV（ P = 0.015）是 MVI 的独立预测因子。在受试者工作特征曲线中，TLG 预测 MVI 的 AUC 值为 0.645，MTV 预测 MVI 的 AUC 值为 0.635。肿瘤大小≥5 cm、T3-4、TLG＞400.67 和 MTV＞80.58 的患者 MVI 发生率较高。
结论
18 F-FDG PET/CT 代谢参数与 MVI 相关，可作为预测 HCC 患者 LT 前 MVI 的一种非侵入性技术。
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