Non-Small Cell Lung Cancer Treated with Erlotinib: Heterogeneity of 18F-FDG Uptake at PET-Association with Treatment Response and Prognosis
Non-Small Cell Lung Cancer Treated with Erlotinib: Heterogeneity of 18F-FDG Uptake at PET-Association with Treatment Response and Prognosis
复制标题
DOI：
10.1148/radiol.2015141309
复制
发表时间：
2015-09-01
期刊：
影响因子：
19.7
通讯作者：
Chua, Sue
中科院分区：
文献类型：
--
作者：
Cook, Gary J. R.;O'Brien, Mary E.;Chua, Sue
目的：为了确定非小细胞肺癌（NSCLC）的氟18（F-18）氟脱氧葡萄糖（FDG）正电子发射断层扫描（PET）图像上的一阶和高阶纹理特征（a）在基线时，（B）在6周时，或（c）在基线和6周之间的百分比变化是否可以预测用厄洛替尼治疗的患者的响应或存活。获得了机构审查委员会的批准，用于对获得知情同意的前瞻性单中心研究的数据进行事后分析。该研究纳入了47例NSCLC患者，他们在基线（n = 47）和开始厄洛替尼治疗后6周（n = 40）接受了F-18-FDG PET/计算机断层扫描（CT）。在所有F-18-FDG PET研究中，测量了反映图像异质性的一阶和高阶原发性肿瘤纹理特征、标准化摄取值、代谢肿瘤体积和总病变糖酵解。通过使用实体瘤疗效评价标准（RECIST）对12周时获得的CT图像（n = 32）评估厄洛替尼的疗效。PET参数、总生存期（OS）和基于RECIST的治疗反应之间的关联分别通过考克斯和logistic回归分析进行检验。根据12周时的CT RECIST，有21例无应答者和11例应答者。对厄洛替尼的反应与异质性降低相关（一阶标准差，P = 0.01;熵，P = 0.001;均匀性，P = 0.001）。在多变量分析中，6周时的高阶对比度（P = 0.002）和一阶熵的百分比变化（P = 0.03）与生存率独立相关。一阶熵的百分比变化也与治疗反应独立相关（P = 0.01）。结论：厄洛替尼的反应与F-18-FDG PET异质性降低相关。一阶熵的变化与OS和治疗反应独立相关。(C)RSNA，2015年
Purpose: To determine if first-order and high-order textural features on fluorine 18 (F-18) fluorodeoxyglucose (FDG) positron emission tomography (PET) images of non-small cell lung cancer (NSCLC) (a) at baseline, (b) at 6 weeks, or (c) the percentage change between baseline and 6 weeks can predict response or survival in patients treated with erlotinib.Materials and Methods: Institutional review board approval was obtained for post hoc analysis of data from a prospective single-center study for which informed consent was obtained. The study included 47 patients with NSCLC who underwent F-18-FDG PET/computed tomography (CT) at baseline (n = 47) and 6 weeks (n = 40) after commencing treatment with erlotinib. First-order and high-order primary tumor texture features reflecting image heterogeneity, standardized uptake values, metabolic tumor volume, and total lesion glycolysis were measured for all F-18-FDG PET studies. Response to erlotinib was assessed by using the Response Evaluation Criteria in Solid Tumors (RECIST) on CT images obtained at 12 weeks (n = 32). Associations between PET parameters, overall survival (OS), and RECIST-based treatment response were tested by Cox and logistic regression analyses, respectively.Results: Median OS was 14.1 months. According to CT RECIST at 12 weeks, there were 21 nonresponders and 11 responders. Response to erlotinib was associated with reduced heterogeneity (first-order standard deviation, P = .01; entropy, P = .001; uniformity, P = .001). At multivariable analysis, high-order contrast at 6 weeks (P = .002) and percentage change in first-order entropy (P = .03) were independently associated with survival. Percentage change in first-order entropy was also independently associated with treatment response (P = .01).Conclusion: Response to erlotinib is associated with reduced heterogeneity at F-18-FDG PET. Changes in first-order entropy are independently associated with OS and treatment response. (C) RSNA, 2015