Tamer Fatih, Mammadli Khayala, Yararbaş Ülkem
Ege University Faculty of Medicine, Department of Nuclear Medicine, İzmir, Türkiye.
Mol Imaging Radionucl Ther. 2025 Jun 3;34(2):114-121. doi: 10.4274/mirt.galenos.2025.62134. Epub 2025 May 14.
We aimed to evaluate the relationship of Fluorine-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) parameters with diagnostic efficacy, disease management and prognosis in patients with cholangiocarcinoma (CCA). The prognostic value of the spleen/liver F-FDG uptake ratio was also investigated.
The clinical and imaging findings of 39 patients who met the diagnostic criteria and underwent F-FDG PET/CT imaging for staging between 2013 and 2023 were retrospectively analysed.
The tumour was intrahepatic in 34 patients and extrahepatic in 5 patients. PET/CT detected nodal involvement in 21 patients (53.8%) and distant metastases in 35 patients (89.7%). Fourteen cases (35.9%) had regional-distant metastases detected by PET/CT but not by magnetic resonance imaging/CT, and the stage of the disease changed accordingly. SUV, SUV, metabolic tumor volume, tumour lesion glycolysis, tumor-to-liver ratio (tumour/liver parenchyma SUV), tumor-to-background ratio (tumour/blood pool SUV), tumor-stroma ratio (tumour/spleen parenchyma SUV), and standardized liver ratio (SLR) (spleen/liver SUV) did not differ based on tumour location. Recurrence occurred in 14 patients (35.9%), and 2 patients survived. When the cut-off values for the parameters were determined by the Youden index, progression-free survival (PFS) was significantly shorter in patients with an SLR value of less than 0.94 compared to the others (p=0.04). Nodal involvement, metastatic location, and other PET/CT parameters had no significant effect on PFS and overall survival.
Our results highlight the efficacy of F-FDG PET/CT in staging nodal and distant metastases, similar to several studies in patients with CCA. Although SLR was found to have significant efficacy in PFS among the parameters we analysed, it is appropriate to evaluate the prognostic significance of these parameters in larger patient groups.
我们旨在评估氟代脱氧葡萄糖（F-FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）参数与胆管癌（CCA）患者的诊断效能、疾病管理及预后之间的关系。同时还研究了脾脏/肝脏F-FDG摄取率的预后价值。
回顾性分析了2013年至2023年间39例符合诊断标准并接受F-FDG PET/CT成像进行分期的患者的临床和影像检查结果。
34例患者肿瘤位于肝内，5例位于肝外。PET/CT检测到21例患者（53.8%）有淋巴结受累，35例患者（89.7%）有远处转移。14例（35.9%）患者经PET/CT检测出区域-远处转移，但磁共振成像/CT未检测到，疾病分期相应改变。SUV、SUV、代谢肿瘤体积、肿瘤病变糖酵解、肿瘤与肝脏比值（肿瘤/肝实质SUV）、肿瘤与背景比值（肿瘤/血池SUV）、肿瘤与基质比值（肿瘤/脾实质SUV）以及标准化肝脏比值（SLR）（脾脏/肝脏SUV）在肿瘤位置方面无差异。14例患者（35.9%）复发，2例存活。当通过约登指数确定参数的临界值时，SLR值小于0.94的患者无进展生存期（PFS）明显短于其他患者（p=0.04）。淋巴结受累、转移部位及其他PET/CT参数对PFS和总生存期无显著影响。
我们的结果突出了F-FDG PET/CT在淋巴结和远处转移分期方面的效能，这与CCA患者的多项研究结果相似。尽管在我们分析的参数中发现SLR对PFS有显著效能，但在更大的患者群体中评估这些参数的预后意义才是合适的。
