[1]龚伟,于丽娟,田墨涵,等.18F-FDG PET/CT代谢参数在子宫内膜癌术前风险评估中的价值[J].国际放射医学核医学杂志,2018,(4):301-306.[doi:10.3760/cma.j.issn.1673-4114.2018.04.002]
 Gong Wei,Yu Lijuan,Tian Mohan,et al.The value of 18F-FDG PET/CT metabolic parameters in preoperative risk stratification of endometrial carcinoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):301-306.[doi:10.3760/cma.j.issn.1673-4114.2018.04.002]
点击复制

18F-FDG PET/CT代谢参数在子宫内膜癌术前风险评估中的价值(/HTML)
分享到:

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
期数:
2018年第4期
页码:
301-306
栏目:
临床研究
出版日期:
2018-07-25

文章信息/Info

Title:
The value of 18F-FDG PET/CT metabolic parameters in preoperative risk stratification of endometrial carcinoma
作者:
龚伟1 于丽娟1 田墨涵2 梁邦玉2
1. 570311 海口, 海南省肿瘤医院影像中心;
2. 150081, 哈尔滨医科大学附属肿瘤医院PET/CT中心
Author(s):
Gong Wei1 Yu Lijuan1 Tian Mohan2 Liang Bangyu2
1. Imaging Center, Hainan Cancer Hospital, Haikou 570311, China;
2. PET/CT Center, Harbin Medical University Cancer Hospital, Harbin 150081, China(Tian MH, Liang BY
关键词:
子宫内膜肿瘤正电子发射断层显像计算机体层摄影术肿瘤代谢体积总糖酵解最大标准化摄取值
Keywords:
Endometrial neoplasmsPositron emission tomography computed tomographyMetabolic tumor volumeTotal lesion glycolysisMaximum standardized uptake value
DOI:
10.3760/cma.j.issn.1673-4114.2018.04.002
摘要:
目的 回顾性分析18F-FDG PET/CT代谢参数最大标准化摄取值(SUVmax)、肿瘤代谢体积(MTV)及总糖酵解量(TLG)在预测高风险和低风险子宫内膜癌患者中的意义及诊断效能。方法 收集2008年8月至2017年1月术前行PET/CT全身检查的44例子宫内膜癌患者的临床病理资料,根据病变的侵袭程度及临床病理特点,将患者分为高风险组(21例)和低风险组(23例)。应用美国GE PET/CT AW4.6工作站的PET VACR软件,采用百分阈值法(以SUVmax的40%为阈值)自动勾画感兴趣区,软件自动生成SUVmax、MTV和TLG。应用Mann-Whithney U检验分析高、低风险组的SUVmax、MTV和TLG之间的差别;应用受试者工作特征(ROC)曲线分析SUVmax、MTV和TLG能否预测高、低风险组及预测效能。结果 高、低风险组的SUVmax分别为14.54±6.54、13.06±8.51,差异无统计学意义(Z=-1.163,P=0.245)。高风险组的MTV[(17.86±19.32)mL]和TLG[(152.00±178.74)g]显著高于低风险组[(MTV=(7.38±5.00)mL,TLG=(54.89±80.00)g],差异均有统计学意义(Z=-2.808,P=0.005;Z=-3.395,P=0.001);分析ROC曲线发现MTV和TLG可以预测高低风险组,而SUVmax不能预测高低风险组。分别以MTV=7.44 mL和TLG=55.52 g为截断点预测效能最佳,MTV和TLG的灵敏度、特异度、阴性预测值、阳性预测值和准确率分别为76%、61%、72%、68%、70%和81%、74%、81%、77%、78%。结论 18F-FDG PET/CT代谢参数MTV和TLG在预测子宫内膜癌的高低风险性方面优于SUVmax
Abstract:
Objective To investigate the importance of maxium standardized uptake value(SUVmax), metabolizable tumor volume (MTV), and total glycolysis volume (TLG) of 18F-FDG PET/CT in predicting high-and low-risk groups of patients with endometrial cancer and their diagnostic efficacy. Methods We retrospectively collected the clinical pathological data of 44 patients with endometrial cancer from August 2008 to February 2017 in the PET/CT center at our hospital. The patients were divided into high-and low-risk groups based on the degree of invasion and clinicopathological features of the disease. Region of interest was automatically delineated via the percent threshold method(40% threshold of SUVmax) by using the PET VACR software of GE PET/CT AW4.6 workstation in the United States. SUVmax, MTV, and TLG were automatically generated. Mann-Whitney U test was performed to analyze the differences between SUVmax, MTV, and TLG in the high-and low-risk groups. ROC curves were obtained to determine whether SUVmax, MTV, and TLG could predict high-and low-risk groups and to reveal their predictive power. Results The high-and low-risk groups yielded SUVmax of 14.54±6.54 and 13.06±8.51, respectively, and their difference was not significant(Z=-1.163, P=0.245). MTV and TLG[(MTV=17.86±19.32) mL],[TLG=(152.00±178.74) g] of the high-risk group were significantly higher than those of the low-risk group[(MTV=(7.38±5.00) mL],[TLG=(54.89±80.00) g], their difference was significant(Z=-2.808, P=0.005; Z=-3.395, P=0.001). The ROC curve analysis indicated that high-and low-risk groups could be predicted by MTV and TLG but not by SUVmax. The optimal prediction effectiveness was obtained at MTV=7.44 mL and TLV=55.52 g. The sensitivity, specificity, negative predictive value, positive predictive value, and precision rate were 76%, 61%, 72%, 68%, and 70% in MTV and 81%, 74%, 81%, 77%, and 78% in TLG, respectively. Conclusion MTV and TLG are superior to SUVmax in predicting high-and low-risk groups of endometrial cancer.

参考文献/References:

[1] 廖琴平, 杨曦. 子宫内膜癌筛查及早期诊断的现状及展望[J]. 实用妇产科杂志, 2015, 31(7):481-484. DOI:1003-6946(2015)07-481-0. Liao QP, Yang X. Current status and Prospect of screening andearly diagnosis of endometrial cancer[J]. J Pract Obstet Gynecol, 2015, 31(7):481-484.
[2] Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009[J]. CA Cancer J Clin, 2009, 59(4):225-249. DOI:10.3322/caac.20006.
[3] Nakamura K, Kodama J, Okumura Y, et al. The SUVmax of 18F-FDG PET correlates with histological grade in endometrial cancer[J]. Int J Gynecol Cancer, 2010, 20(1):110-115. DOI:10.1111/IGC.0b013e3181c3a288.
[4] Nakamura K, Hongo A, Kodama J, et al. The measurement of SUVmax of the primary tumor is predictive of prognosis for patients with endometrial cancer[J]. Gynecol Oncol, 2011, 123(1):82-87. DOI:10.1016/j.ygyno.2011.06.026.
[5] Lee HJ, Ahn BC, Hong CM, et al. Preoperative risk stratification using 18F-FDG PET/CT in women with endometrial cancer[J]. Nuklearmedizin, 2011, 50(5):204-213. DOI:10.3413/nukmed-0375-10-12.
[6] Kitajima K, Kita M, Suzuki K, et al. Prognostic significance of SUVmax (maximum standardized uptake value) measured by[18F]FDG PET/CT in endometrial cancer[J]. Eur J Nucl Med Mol Imaging, 2012, 39(5):840-845. DOI:10.1007/s00259-011-2057-9.
[7] Antonsen SL, Jensen LN, Loft A, et al. MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer-a multicenter prospective comparative study[J]. Gynecol Oncol, 2013, 128(2):300-308. DOI:10.1016/j.ygyno.2013.01.019.
[8] Walentowicz-Sadlecka M, Malkowski B, Walentowicz P, et al. The preoperative maximum standardized uptake value measured by 18F-FDG PET/CT as an independent prognostic factor of overall survival in endometrial cancer patients[J/OL]. Biomed Res Int, 2014, 2014:234813[2017-11-28]. https://www.hindawi.com/journals/bmri/2014/234813/. DOI:10.1155/2014/234813.
[9] Ghooshkhanei H, Treglia G, Sabouri G, et al. Risk stratification and prognosis determination using 18F-FDG PET imaging in endometrial cancer patients:a systematic review and meta-analysis[J]. Gynecol Oncol, 2014,132(3):669-676. DOI:10.1016/j.ygyno.2014.01.039.
[10] Pak K, Cheon GJ, Nam HY, et al. Prognostic value of metabolic tumor volume and total lesion glycolysis in head and neck cancer:a systematic review and meta-analysis[J]. J Nucl Med, 2014, 55(6):884-890. DOI:10.2967/jnumed.113.133801.
[11] Liu FY, Chao A, Lai CH, et al. Metabolic tumor volume by 18F-FDG PET/CT is prognostic for stage IVB endometrial carcinoma[J]. Gynecol Oncol, 2012, 125(3):566-571. DOI:10.1016/j.ygyno.2012. 03.021.
[12] Chung HH, Lee I, Kim HS, et al. Prognostic value of preoperative metabolic tumor volume measured by 18F-FDG PET/CT and MRI in patients with endometrial cancer[J]. Gynecol Oncol, 2013, 130(3):446-451. DOI:10.1016/j.ygyno.2013.06.021.
[13] Crivellaro C, Signorelli M, Guerra L, et al. Tailoring systematic lymphadenectomy in high-risk clinica l early stage endometrial cancer:the role of 18F-FDG PET/CT[J]. Gynecol Oncol, 2013, 130(2):306-311. DOI:10.1016/j.ygyno.2013.05.011.
[14] Shim SH, Kim DY, Lee DY, et al. Metabolic tumour volume and total lesion glycolysis, measured using preoperative 18F-FDG PET/CT, predict the recurrence of endometrial cancer[J]. BJOG, 2014, 121(9):1097-1106. DOI:10.1111/1471-0528. 12543.
[15] Sudo S, Hattori N, Manabe O, et al. FDG PET/CT diagnostic criteria may need adjustment based on MRI to estimate the presurgical risk of extrapelvic infiltration in patients with uterine endometrial cancer[J]. Eur J Nucl Med Mol Imaging, 2015, 42(5):676-684. DOI:10.1007/s00259-014-2964-7.
[16] Kitajima K, Suenaga Y, Ueno Y, et al. Preoperative risk stratification using metabolic parameters of 18F-FDG PET/CT in patients with endometrial cancer[J]. Eur J Nucl Med Mol Imaging, 2015, 42(8):1268-1275. DOI:10.1007/s00259-015-3037-2.
[17] Benedetti PP, Basile S, Maneschi F, et al. Systematic pelvic lymphadenectomy vs. no lymphadenectomy in early-stage endometrial carcinoma:randomized clinical trial[J]. J Natl Cancer Inst, 2008, 100(23):1707-1716. DOI:10.1093/jnci/djn397.
[18] Kitchener H, Swart AM, Qian Q, et al. Efficacy of systematic pelvic lymphadenectomy in endometrial cancer (MRC ASTEC trial):a randomised study[J]. Lancet, 2009, 373(9658):125-136. DOI:10.1016/S0140-6736(08)61766-3.
[19] Kim HJ, Cho A, Yun M, et al. Comparison of FDG PET/CT and MRI in lymph node staging of endometrial cancer[J]. Ann Nucl Med, 2016, 30(2):104-113. DOI:10.1007/s12149-015-1037-8.
[20] Kitajima K, Murakami K, Yamasaki E, et al. Accuracy of integrated FDG-PET/contrast-enhanced CT in detecting pelvic and paraaortic lymph node metastasis in patients with uterine cancer[J]. Eur Radiol, 2009, 19(6):1529-1536. DOI:10.1007/s00330-008-1271-8.
[21] Colombo N, Creutzberg C, Amant F, et al. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer:diagnosis, treatment and follow-up[J]. Ann Oncol, 2016, 27(1):16-41. DOI:10.1093/annonc/mdv484.
[22] Tsujikawa T, Yoshida Y, Kudo T, et al. Functional images reflect aggressiveness of endometrial carcinoma:estrogen receptor expression combined with 18F-FDG PET[J]. J Nucl Med, 2009, 50(10):1598-1604. DOI:10.2967/jnumed.108.060145.
[23] 张凤仙, 张建, 陈素芸, 等. 18F-FDG PET/CT显像SUVmax对子宫内膜癌术前浸润及转移的评估价值[J]. 中华核医学与分子影像杂志, 2017, 37(2):75-80. DOI:10.3760/cma.j.issn.2095-2848. 2017. 02.003. Zhang FX, Zhang J, Chen SY, et al. Value of 18F-FDG PET/CT SUVmax for preoperative assessment of primary tumor infiltration and metastases in patients with endometrial cancer[J]. Chin J Nucl Med Mol Imaging, 2017, 37(2):75-80.
[24] Haldorsen IS, Salvesen HB. What is the best preoperative imaging for endometrial cancer?[J]. Curr Oncol Rep, 2016, 18(4):25. DOI:10.1007/s11912-016-0506-0.
[25] Wright JD, Barrena MNI, Sehouli J, et al. Contemporary management of endometrial cancer[J]. Lancet, 2012, 379(9823):1352-1360. DOI:10.1016/S0140-6736(12)60442-5.

相似文献/References:

[1]薛艳,安瑞芳.放射免疫显像在妇科肿瘤中的研究与应用[J].国际放射医学核医学杂志,2006,30(1):36.
 XUE Yan,AN Rui-fang.A research on radioimmunoimaging and its application in diagnosis of gynecological tumors[J].International Journal of Radiation Medicine and Nuclear Medicine,2006,30(4):36.
[2]陈挺,张宏,田梅.18F-FDG PET/CT代谢半定量参数在非小细胞肺癌预后评估中的价值[J].国际放射医学核医学杂志,2018,(3):269.[doi:10.3760/cma.j.issn.1673-4114.2018.03.014]
 Chen Ting,Zhang Hong,Tian Mei.Prognostic evaluation of patients with non-small cell lung cancer by using semi-quantitative metabolic parameters of 18F-FDG PET/CT[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):269.[doi:10.3760/cma.j.issn.1673-4114.2018.03.014]
[3]杜芬,胡珊,梁梦,等.18F-FDG PET/CT显像在甲状腺偶发瘤良恶性诊断中的研究进展[J].国际放射医学核医学杂志,2018,(3):274.[doi:10.3760/cma.j.issn.1673-4114.2018.03.015]
 Du Fen,Hu Shan,Liang Meng,et al.Development in the diagnosis of benign and malignant thyroid incidentalomas by 18F-FDG PET/CT imaging[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):274.[doi:10.3760/cma.j.issn.1673-4114.2018.03.015]
[4]高之晔,韩星敏.放射性核素标记的胆碱在PET/CT肿瘤显像中的应用[J].国际放射医学核医学杂志,2018,(3):280.[doi:10.3760/cma.j.issn.1673-4114.2018.03.016]
 Gao Zhiye,Han Xingmin.Application of radionuclide-labeled choline in PET/CT tumor imaging[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):280.[doi:10.3760/cma.j.issn.1673-4114.2018.03.016]
[5]孙晓琰,常城,雷贝,等.18F-FDG PET/CT在肺癌性淋巴管病的影像学特征及诊断价值[J].国际放射医学核医学杂志,2018,(4):295.[doi:10.3760/cma.j.issn.1673-4114.2018.04.001]
 Sun Xiaoyan,Chang Cheng,Lei Bei,et al.Imaging features and diagnostic value of 18F-FDG PET/CT in pulmonary lymphangitic carcinomatosis[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):295.[doi:10.3760/cma.j.issn.1673-4114.2018.04.001]
[6]段晓蓓,陈相猛,黄斌豪,等.18F-FDG PET/CT显像在肾上腺转移瘤中的诊断价值和预测分析[J].国际放射医学核医学杂志,2018,(4):307.[doi:10.3760/cma.j.issn.1673-4114.2018.04.003]
 Duan Xiaobei,Chen Xiangmeng,Huang Binhao,et al.18F-FDG PET/CT diagnostic value and predictive analysis in adrenal metastasis lesions[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):307.[doi:10.3760/cma.j.issn.1673-4114.2018.04.003]
[7]麻广宇,刘家金,徐白萱,等.11C-乙酸盐PET/CT显像在中、高分化肝细胞肝癌复发与转移监测中的应用研究[J].国际放射医学核医学杂志,2018,(4):312.[doi:10.3760/cma.j.issn.1673-4114.2018.04.004]
 Ma Guangyu,Liu Jiajin,Xu Baixuan,et al.Application of 11C-acetate PET/CT imaging in the detection of recurrence and metastasis of hepatocellular carcinoma with intermediate and high differentiation[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):312.[doi:10.3760/cma.j.issn.1673-4114.2018.04.004]
[8]谭延林,董楚宁,王云华.18F-FDG PET/CT在肺癌疗效评估中的价值[J].国际放射医学核医学杂志,2018,(4):357.[doi:10.3760/cma.j.issn.1673-4114.2018.04.013]
 Tan Yanlin,Dong Chuning,Wang Yunhua.The value of 18F-FDG PET/CT on evaluating therapeutic effect in the treatment of lung cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):357.[doi:10.3760/cma.j.issn.1673-4114.2018.04.013]
[9]刘道佳,吴君心,唐明灯,等.18F-FLT PET/CT显像评估复发脑胶质瘤患者预后的价值[J].国际放射医学核医学杂志,2018,(5):403.[doi:10.3760/cma.j.issn.1673-4114.2018.05.003]
 Liu Daojia,Wu Junxin,Tang Mingdeng,et al.Prognostic value of 18F-FLT PET/CT imaging in patients with recurrent gliomas[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):403.[doi:10.3760/cma.j.issn.1673-4114.2018.05.003]
[10]赵竞,张占文,马慧,等.PET/CT显像剂18F-氟丙酸在肝癌中的生物学评估[J].国际放射医学核医学杂志,2018,(5):414.[doi:10.3760/cma.j.issn.1673-4114.2018.05.005]
 Zhao Jing,Zhang Zhanwen,Ma Hui,et al.Biological evaluation of PET/CT imaging agent 18F-fluoropropionic acid in hepatocellular carcinoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2018,(4):414.[doi:10.3760/cma.j.issn.1673-4114.2018.05.005]

备注/Memo

备注/Memo:
收稿日期:2017-11-29。
基金项目:哈尔滨市科技厅科技创新基金资助(2016RAXYJ066)
通讯作者:于丽娟,Email:yulijuan2003@126.com
更新日期/Last Update: 2018-07-25