Huang Shuhui, Zhang Yaowen, Zhang Wei, Tian Tian, Dai Hongyuan, Qi Mengfang, Su Minggang, Zeng Hao, Huang Rui
Department of Nuclear Medicine, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, People's Republic of China.
Department of Urology, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, People's Republic of China.
Ann Nucl Med. 2025 Mar 15. doi: 10.1007/s12149-025-02039-2.
This study aimed to comprehensively evaluate the performance of fluorine-18 fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) and investigate the association between metabolic parameters, programmed cell death ligand 1 (PD-L1) expression, and prognosis in patients with fumarate hydratase-deficient renal cell carcinoma (FHRCC).
Twenty-nine patients with FHRCC were prospectively enrolled from May 2020 to February 2023 for F-FDG PET/CT. The maximum standardized uptake value (SUVmax), peak standardized uptake value (SUVpeak), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of primary/recurrent tumors were analyzed. The relationship between PET metabolic parameters, clinicopathological features and prognosis were evaluated.
Primary/recurrent and metastatic lesions showed FDG avidity, without metabolic differences between them. In our analysis, SUVmax of whole body (WB-SUVmax), SUVpeak of whole body (WB-SUVpeak), MTV of whole body (WB-MTV), and TLG of whole body (WB-TLG) were associated with the expression of PD-L1. The optimal cut-off values of WB-SUVmax, WB-SUVpeak, WB-MTV, and WB-TLG for predicting positive PD-L1 expression were 9.86 (AUC 0.814), 6.92 (AUC 0.848), 19.61 cm (AUC 0.803), and 58.39 g (AUC 0.841), respectively. Survival analysis further demonstrated that patients with WB-SUVpeak ≥ 8.92 had shorter time to progression than those with WB-SUVpeak < 8.92 (11.0 mo vs. 21.0 mo, P = 0.047).
F-FDG PET/CT is effective in detecting FHRCC lesions due to their hypermetabolic nature. PET metabolic parameters can serve as predictors of positive PD-L1 expression, with higher values observed in FHRCC patients with positive PD-L1 expression. Additionally, WB-SUVpeak is a significant predictor of prognosis in patients with FHRCC.
本研究旨在全面评估氟-18氟脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）的性能，并探讨代谢参数、程序性细胞死亡配体1（PD-L1）表达与延胡索酸水合酶缺陷型肾细胞癌（FHRCC）患者预后之间的关联。
2020年5月至2023年2月前瞻性纳入29例FHRCC患者进行F-FDG PET/CT检查。分析原发/复发性肿瘤的最大标准化摄取值（SUVmax）、峰值标准化摄取值（SUVpeak）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。评估PET代谢参数、临床病理特征与预后之间的关系。
原发/复发及转移病灶均显示FDG摄取，二者之间无代谢差异。在我们的分析中，全身SUVmax（WB-SUVmax）、全身SUVpeak（WB-SUVpeak）、全身MTV（WB-MTV）和全身TLG（WB-TLG）与PD-L1表达相关。预测PD-L1阳性表达的WB-SUVmax、WB-SUVpeak、WB-MTV和WB-TLG的最佳截断值分别为9.86（AUC 0.814）、6.92（AUC 0.848）、19.61 cm（AUC 0.803）和58.39 g（AUC 0.841）。生存分析进一步表明，WB-SUVpeak≥8.92的患者进展时间短于WB-SUVpeak<8.92的患者（11.0个月对21.0个月，P = 0.047）。
由于FHRCC病变具有高代谢特性，F-FDG PET/CT在检测FHRCC病变方面有效。PET代谢参数可作为PD-L1阳性表达的预测指标，在PD-L1阳性表达的FHRCC患者中观察到更高的值。此外，WB-SUVpeak是FHRCC患者预后的重要预测指标。
