Imaging features and prognostic value of 18F-FDG PET/CT detection of soft-tissue metastasis from lung cancer: a retrospective study
Imaging features and prognostic value of 18F-FDG PET/CT detection of soft-tissue metastasis from lung cancer: a retrospective study
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~(18)F-FDG PET/CT检测肺癌软组织转移的影像学特征及预后价值的回顾性研究
DOI：
10.1186/s12885-020-07080-0
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发表时间：
2020-06
期刊：
影响因子：
3.8
通讯作者：
Chen Yue
中科院分区：
文献类型：
--
作者：
Xu Tingting;Zhang Xinyi;Zhang Shumao;Liu Chunfeng;Fu Wenhui;Zeng Chengrun;Chen Yue
背景
软组织转移（STM）是一种相对罕见的，但并不例外，肺癌的表现。本研究的目的是使用氟-18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET/CT）评估肺癌STM的成像特征，并评估基线PET/CT检测到的STM对患者生存的影响。
方法
在2013年1月至2018年9月期间在我院接受18F-FDG PET/CT的4543例肺癌患者中，85例被诊断为STM（基线PET/CT时78例，再分期PET/CT时7例），并被纳入成像研究。我们对基线PET/CT检查时有和无STM的4期肺癌患者（每组n = 78）进行了比较生存分析，并进行了单变量和多变量分析，以研究影响肺癌预后的因素。
结果
18F-FDG PET/CT共识别出219个病灶：PET检出215个，CT检出139个。肌肉STM主要分布在臀部和上肢肌肉，而皮下STM主要分布在胸部、腹部和背部。68例患者在常规18F-FDG PET/CT分期时偶然发现STM。6例患者检出孤立性STM，PET/CT检查结果影响肿瘤分期和治疗。在基线PET/CT时，有和无STM的患者之间的1年、3年和5年生存率无显著差异。脑和肾上腺转移，而不是STM，与4期肺癌的预后不良。
结论
我们描述了肺癌STM的PET/CT影像学特征，证实PET/CT可以发现未被怀疑的STM，从而改变一些患者的分期和治疗。我们的分析表明，STM是不是一个有用的晚期肺癌患者的预后指标，而脑和肾上腺转移预示着预后不良。
Background
Soft-tissue metastasis (STM) is a relatively rare, but not exceptional, manifestation of lung cancer. The purpose of this study was to evaluate the imaging features of STM from lung cancer using fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), and assess the impact of STM detected at baseline PET/CT on patient survival.
Methods
Out of 4543 patients with lung cancer who underwent 18F-FDG PET/CT in our hospital between January 2013 and September 2018, 85 were diagnosed with STM (78 at baseline PET/CT and 7 at restaging PET/CT) and included in the imaging study. We conducted a comparative survival analysis between patients with stage 4 lung cancer with and without STM at baseline PET/CT (n = 78 in each group) and performed univariate and multivariate analyses to investigate the factors affecting the prognosis of lung cancer.
Results
A total of 219 lesions were identified by 18F-FDG PET/CT: 215 were detected by PET and 139 by CT. Muscle STM were primarily found in the hip and upper limb muscle, whereas subcutaneous STM were mainly distributed in the chest, abdomen, and back. In 68 patients, STM were found incidentally during routine 18F-FDG PET/CT staging. Isolated STM were detected in 6 patients, whose tumor staging and treatment were affected by PET/CT findings. There were no significant differences in the 1-, 3-, and 5-year survival rates between patients with and without STM at baseline PET/CT. Brain and adrenal metastases, but not STM, were associated with poor prognosis of stage 4 lung cancer.
Conclusions
We described the PET/CT imaging characteristics of STM from lung cancer, and confirmed that PET/CT can detect unsuspected STM to change the staging and treatment of some patients. Our analysis indicates that STM is not a useful prognostic indicator for patients with advanced lung cancer, while brain and adrenal metastases portend a poor prognosis.
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