18F-FDG PET/CT代谢参数预测原发性宫颈癌预后  

18 F-FDG PET/CT metabolic parameters for prognosis of primary cervical cancer

作　　者：周星 姚玉唐 李川 王潇雄 江骁[1] 申太鹏 陆皓[1] 陈世容[1] 肖定琼[1] 赵檬 游金辉[2] 程祝忠[1,2] ZHOU Xing;YAO Yutang;LI Chuan;WANG Xiaoxiong;JIANG Xiao;SHEN Taipeng;LU Hao;CHEN Shirong;XIAO Dingqiong;ZHAO Meng;YOU Jinhui;CHENG Zhuzhong(Radiation Oncology Key Laboratory of Sichuan Province,PET/CT Centre,Sichuan Cancer Hospital,Chengdu 610041,China;Department of Nuclear Medicine,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,China)

机构地区：[1]放射肿瘤学四川省重点实验室,四川省肿瘤医院PET/CT中心,四川成都610041 [2]川北医学院附属医院核医学科,四川南充637000

出　　处：《中国医学影像技术》2020年第5期726-731,共6页Chinese Journal of Medical Imaging Technology

基　　金：四川省科技计划项目(2018SZ0210、2019YJ0574)。

摘　　要：目的评估根据不同百分比最大标准摄取值(SUV max)阈值分段代谢参数预测经同步放射化学治疗(CCRT)宫颈癌患者预后的价值。方法对45例CCRT前宫颈癌患者行18 F-FDG PET/CT检查,获得代谢参数最大标准摄取值(SUV max)、代谢肿瘤体积(MTV)及病灶糖酵解总量(TLG)。利用不同百分比SUV max阈值(范围10%~85%,以5%递增)分割法分割MTV和TLG,采用ROC曲线分析找出最佳截断值,以Kaplan-Meier曲线进行生存分析。结果CCRT后14例肿瘤进展(进展组),31例无进展(非进展组),组间SUV max、MTV 10%、MTV 75%~MTV 85%、TLG 75%~TLG 85%差异均无统计学意义(P均>0.05),MTV 15%~MTV 70%、TLG 10%~MTV 70%差异有统计学意义(P均<0.05)。以40%SUV max为阈值预测宫预后作用最强。MTV 40%的截断值为21.09时AUC最大(AUC=0.823),敏感度为78.60%,特异度为87.10%;TLG 40%的截断值为136.71时AUC最大(AUC=0.788),敏感度为78.60%,特异度为77.40%。结论根据18 F-FDG PET/CT代谢参数MTV 40%和TLG 40%可预测CCRT后宫颈癌患者预后。Objective To assess the predictive value of metabolic parameters with different maximum standard intake value(SUV max)threshold segmentations calculated from 18 F-FDG PET/CT before concurrent chemoradiotherapy(CCRT)of cervical cancer.Methods Totally 45 patients underwent 18 F-FDG PET/CT before CCRT,and SUV max,maximum standard intake value(MTV)and metabolic tumor volume(TLG)were recorded.MTV and TLG were automatically segmented using different percentage SUV max threshold segmentations(10%-85%,increased by 5%).Receiver operating characteristic(ROC)curve analysis was performed in order to obtain the cut-off values of MTV and TLG.Kaplan-Meier method was used for survival analysis.Results SUV max,MTV 10%,MTV 75%-MTV 85%and TLG 75%-TLG 85%were not significantly different(all P>0.05),whereas significant differences of MTV 15%-MTV 70%and TLG 10%-TLG 70%were found between 2 groups(all P<0.05).40%SUV max had the strongest prediction capability for prognosis.Based on ROC curve analysis,the cut-off value of MTV 40%was 21.09,with sensitivity of 78.60%,specificity of 87.10%and AUC of 0.823,while the cut-off value of TLG 40%was 136.71,with sensitivity of 78.60%,specificity of 77.40%and AUC of 0.788.Conclusion MTV 40%and TLG 40%calculated from 18 F-FDG PET/CT can be taken as prognostic indicators for cervical cancer after CCRT.

关 键 词：子宫肿瘤 子宫颈 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 

分 类 号：R737.33[医药卫生—肿瘤] R817.4[医药卫生—临床医学]