Lv Yuhu, Zheng Danzha, Wang Ruiping, Zhou Zhangyongxue, Gao Zairong, Lan Xiaoli, Qin Chunxia
Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.
Hubei Key Laboratory of Molecular Imaging.
Clin Nucl Med. 2025 Aug 1;50(8):721-730. doi: 10.1097/RLU.0000000000005942. Epub 2025 May 9.
To evaluate the diagnostic performance of the PET Assisted Reporting System (PARS) in nasopharyngeal carcinoma (NPC) patients without distant metastasis, and to investigate the prognostic significance of the metabolic parameters.
Eighty-three NPC patients who underwent pretreatment 18 F-FDG PET/CT were retrospectively collected. First, the sensitivity, specificity, and accuracy of PARS for diagnosing malignant lesions were calculated, using histopathology as the gold standard. Next, metabolic parameters of the primary tumor were derived using both PARS and manual segmentation. The differences and consistency between the 2 methods were analyzed. Finally, the prognostic value of PET metabolic parameters was evaluated. Prognostic analysis of progression-free survival (PFS) and overall survival (OS) was conducted.
PARS demonstrated high patient-based accuracy (97.2%), sensitivity (88.9%), and specificity (97.4%), and 96.7%, 84.0%, and 96.9% based on lesions. Manual segmentation yielded higher metabolic tumor volume (MTV) and total lesion glycolysis (TLG) than PARS. Metabolic parameters from both methods were highly correlated and consistent. ROC analysis showed metabolic parameters exhibited differences in prognostic prediction, but generally performed well in predicting 3-year PFS and OS overall. MTV and age were independent prognostic factors; Cox proportional-hazards models incorporating them showed significant predictive improvements when combined. Kaplan-Meier analysis confirmed better prognosis in the low-risk group based on combined indicators (χ² = 42.25, P < 0.001; χ² = 20.44, P < 0.001).
Preliminary validation of PARS in NPC patients without distant metastasis shows high diagnostic sensitivity and accuracy for lesion identification and classification, and metabolic parameters correlate well with manual. MTV reflects prognosis, and its combination with age enhances prognostic prediction and risk stratification.
评估PET辅助报告系统（PARS）在无远处转移的鼻咽癌（NPC）患者中的诊断性能，并探讨代谢参数的预后意义。
回顾性收集83例接受治疗前18F-FDG PET/CT检查的NPC患者。首先，以组织病理学为金标准，计算PARS诊断恶性病变的敏感性、特异性和准确性。其次，使用PARS和手动分割法得出原发肿瘤的代谢参数。分析两种方法之间的差异和一致性。最后，评估PET代谢参数的预后价值。进行无进展生存期（PFS）和总生存期（OS）的预后分析。
PARS显示出较高的基于患者的准确性（97.2%）、敏感性（88.9%）和特异性（97.4%），基于病变的准确性、敏感性和特异性分别为96.7%、84.0%和96.9%。手动分割得出的代谢肿瘤体积（MTV）和总病变糖酵解（TLG）高于PARS。两种方法得出的代谢参数高度相关且一致。ROC分析显示代谢参数在预后预测方面存在差异，但总体上在预测3年PFS和OS方面表现良好。MTV和年龄是独立的预后因素；纳入它们的Cox比例风险模型在联合使用时显示出显著的预测改善。Kaplan-Meier分析证实，基于联合指标的低风险组预后更好（χ² = 42.²5，P < 0.001；χ² = 20.44，P < 0.001）。
PARS在无远处转移的NPC患者中的初步验证显示，其在病变识别和分类方面具有较高的诊断敏感性和准确性，代谢参数与手动分割法相关性良好。MTV反映预后，其与年龄联合可增强预后预测和风险分层。
