定量F-FDG PET/CT衍生参数作为预测放射性碘难治性分化型甲状腺癌总生存期的预后因素的效用。
The utility of quantitative F-FDG PET/CT-derived parameters as prognostic factors for predicting overall survival in radioiodine-refractory differentiated thyroid cancer.
作者信息
Son Mai Hong, Phuong Nguyen Thi, Ha Le Ngoc
机构信息
Department of Nuclear Medicine, Hospital 108, Hanoi, Vietnam.
出版信息
Asia Ocean J Nucl Med Biol. 2025;13(2):156-165. doi: 10.22038/aojnmb.2025.84029.1596.
OBJECTIVES
This study investigates the relationship between quantitative F-FDG PET/CT metabolic parameters and overall survival (OS) in patients with radioiodine-refractory differentiated thyroid cancer (RAI-R DTC).
METHODS
We conducted a prospective analysis of 127 patients with RAI-R DTC. Quantitative metabolic parameters including SUV, SUV, SUV, total metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were assessed in F-FDG -avid recurrent or metastatic lesions via F-FDG PET/CT imaging. Patients were monitored for disease progression and mortality for at least one-year post PET/CT imaging. Receiver operating characteristic (ROC) curves were used to establish cut-off values for predicting 5-year mortality, while the Kaplan-Meier method estimated the 5-year survival rate. Univariate and multivariate Cox regression analyses identified prognostic factors associated with OS.
RESULTS
The metabolic parameters derived from F-FDG PET/CT demonstrated high sensitivity and specificity for predicting 5-year OS. ROC curve analysis established optimal cut-off values for SUV (20.27 g/mL), SUV (7.46 g/mL), SUV (7.8 g/mL), TLG (45.74 g/mL×cm³), and MTV (5.78 cm) (AUC: 0.82, 0.78, 0.82, 0.82, and 0.86, respectively; p<0.001). Kaplan-Meier analysis revealed significantly lower OS in patients with higher values of these parameters compared to those with lower ones (survival rates: 42.1% vs. 95.6%, 65.5% vs. 96%, 52.3% vs. 96.3%, 46.5% vs. 97.3%, and 57.3 % vs. 98.3%, respectively; p<0.001). Univariate Cox regression identified SUV, SUV, SUV, TLG, and MTV as significant predictors of 5-year OS (p<0.05). In multivariate analysis, SUV and MTV emerged as independent predictors of OS.
CONCLUSION
Quantitative F-FDG PET/CT-derived parameters are significant predictors of 5-year OS, exhibiting high sensitivity and specificity. Elevated values of these parameters correlate with increased mortality rates. Our findings suggest that SUV and MTV are independent prognostic factors for 5-year OS in patients with radioiodine-refractory DTC.
目的
本研究调查了放射性碘难治性分化型甲状腺癌（RAI-R DTC）患者中F-FDG PET/CT定量代谢参数与总生存期（OS）之间的关系。
方法
我们对127例RAI-R DTC患者进行了前瞻性分析。通过F-FDG PET/CT成像评估F-FDG摄取的复发或转移病灶中的定量代谢参数，包括SUV、SUV、SUV、总代谢肿瘤体积（MTV）和总病变糖酵解（TLG）。在PET/CT成像后至少对患者进行一年的疾病进展和死亡率监测。采用受试者工作特征（ROC）曲线确定预测5年死亡率的临界值，同时采用Kaplan-Meier法估计5年生存率。单因素和多因素Cox回归分析确定与OS相关的预后因素。
结果
F-FDG PET/CT得出的代谢参数对预测5年OS具有高敏感性和特异性。ROC曲线分析确定了SUV（20.27 g/mL）、SUV（7.46 g/mL）、SUV（7.8 g/mL）、TLG（45.74 g/mL×cm³）和MTV（5.78 cm）的最佳临界值（AUC分别为0.82、0.78、0.82、0.82和0.86；p<0.001）。Kaplan-Meier分析显示，这些参数值较高的患者的OS显著低于参数值较低的患者（生存率分别为：42.1%对95.6%、65.5%对96%、52.3%对96.3%、46.5%对97.3%、57.3%对98.3%；p<0.001）。单因素Cox回归确定SUV、SUV、SUV、TLG和MTV是5年OS的显著预测因素（p<0.05）。在多因素分析中，SUV和MTV是OS的独立预测因素。
结论
F-FDG PET/CT得出的定量参数是5年OS的显著预测因素，具有高敏感性和特异性。这些参数值升高与死亡率增加相关。我们的研究结果表明，SUV和MTV是放射性碘难治性DTC患者5年OS的独立预后因素。
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