Peng Yao, Shi Min, Xiong Daxi, Lu Sheng, Miao Ying, Yuan Hong, Yan Chao, Zhu Zhenggang, Li Biao, Yang Zhongyin, Hu Jiajia
Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Oncology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
EJNMMI Res. 2025 Apr 21;15(1):46. doi: 10.1186/s13550-025-01244-4.
Conversion therapy followed by conversion surgery (CS) can improve the prognosis of gastric cancer (GC) patients with peritoneal metastasis (PM). However, patients benefit differently. There is no way to confirm the prognostic benefit non-invasively and early. This retrospective study assessed the value of F-FDG PET/CT after conversion therapy in preoperative assessment and prognostic prediction of GC patients with PM.
Fifty-one GC patients with PM were enrolled. F-FDG PET/CT after conversion therapy helped in preoperative assessment. Its diagnostic accuracy for residual peritoneal lesions was slightly better than contrast-enhanced CT (72.5% vs. 61.2%, P = 0.229), although the difference was not statistically significant. TBR of peritoneal lesions could help preoperative assessment, with TBR of peritoneal lesions to the mediastinal blood pool SUVmax (TBRAmaxp) as the best predictor (cutoff = 0.705, specificity 80%, sensitivity 80%, AUC 0.825, P < 0.001). Additionally, PET/CT could predict prognosis and assess surgical benefit. SUVmax of peritoneal lesions (SUVmaxp) was the best predictor of 24 months survival (cutoff = 1.466, AUC 0.870, P = 0.002, Specificity 77.8%, Sensitivity 83.3%) and metabolic parameters of peritoneal lesions could predict OS and the prognosis of patients who underwent CS.
F-FDG PET/CT provides quantitative imaging indicators for preoperative evaluation and prognostic prediction in GC patients with PM.
转化治疗联合转化手术（CS）可改善伴有腹膜转移（PM）的胃癌（GC）患者的预后。然而，患者的获益程度有所不同。目前尚无无创且早期确认预后获益的方法。本项回顾性研究评估了转化治疗后F-FDG PET/CT在伴有PM的GC患者术前评估及预后预测中的价值。
纳入51例伴有PM的GC患者。转化治疗后的F-FDG PET/CT有助于术前评估。其对腹膜残留病灶的诊断准确性略优于增强CT（72.5%对61.2%，P = 0.229），尽管差异无统计学意义。腹膜病灶的肿瘤代谢比（TBR）有助于术前评估，其中以腹膜病灶与纵隔血池SUVmax的TBR（TBRAmaxp）作为最佳预测指标（截断值 = 0.705，特异性80%，敏感性80%，AUC 0.825，P < 0.001）。此外，PET/CT可预测预后并评估手术获益。腹膜病灶的SUVmax（SUVmaxp）是24个月生存率的最佳预测指标（截断值 = 1.466，AUC 0.870，P = 0.002，特异性77.8%，敏感性83.3%），且腹膜病灶的代谢参数可预测接受CS患者的总生存期（OS）及预后。
F-FDG PET/CT为伴有PM的GC患者的术前评估及预后预测提供了定量影像指标。
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