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定量[18F]FDG PET/CT参数在上腺皮癌中的预后作用

Wiebke Schlötelburg¹, Philipp E Hartrampf², Aleksander Kosmala²

¹Department of Nuclear Medicine, University Hospital Würzburg, Oberdürrbacher Straße 6, 97080, Würzburg, Germany. schloetelb_W@ukw.de.

|February 21, 2024

概括

在上腺皮质癌 (ACC) 中, [18F]FDG PET/CT对转移的视觉评估,而不是定量参数,预测了整体存活率. 基-67指数还表明,在未接受过治疗的ACC患者中,预后较差.

科学领域:

核医学就是核医学.
在瘤学瘤学.
放射学放射学是一门学科.

背景情况:

皮上腺癌 (ACC) 是一种罕见且具有攻击性的内分泌恶性瘤.
准确的预后标记对于指导ACC的治疗策略至关重要.
[18F]FDG PET/CT在瘤学中越来越多地用于分期和评估治疗反应.

研究的目的:

评估基线[18F]FDG PET/CT对未经治疗的ACC患者整体存活期 (OS) 的预后能力.
为了比较定量[18F]FDG PET/CT参数的预后值与转移性疾病的视觉评估.
确定ACC中OS的独立预后因素.

主要方法:

67名先前未接受过治疗的ACC患者的回顾性分析,基线[18F]FDG PET/CT.
包括SUVmax,SUVmean,SUVpeak,MTV和TLG在内的定量参数来自初级瘤.
转移状态 (M0/M1) 通过PET/CT视觉评估. 使用卡普兰-梅尔和考克斯回归进行了生存分析.
对已确定的预后标志物 (如Ki-67.) 进行了调整.

主要成果:

36%的患者患有M0疾病,而64%的患者在诊断时患有M1疾病.
[18F]FDG PET/CT在12%的患者中发现了额外的转移性病变,这些病变仅在CT上是看不见的.
定量PET参数没有显著预测OS (P ≥0.1).
视觉评估M1状态 (HR 13.89,P < 0.001) 和Ki-67指数 (HR 1.29,P < 0.0001) 与增加的死亡率有显著的关联.
在多变量分析中,M1状态 (HR 9.69) 和Ki-67指数 (HR 1.29) 仍然是 OS 的重要预测指标.

结论:

在基线上对转移性疾病的视觉评估 [18F]FDG PET/CT 是治疗先前的ACC中OS的显著预后因素.
定量[18F]FDG PET/CT参数不能为这个队列中的OS提供独立的预后价值.
Ki-67指数也是ACC中较短的OS的独立预测指标.
常规的定量PET分析可能会被遗漏,有利于在初始诊断时进行预后评估的视觉读取.

关键词:

在 ACC ACC ACC ACC ACC ACC ACC ACC ACC ACC ACC 内分泌系统内分泌系统内分泌系统这是一辆SUVmax,SUVmax.幸存的生存方式在以前没有接受过治疗之前.

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