F-18 FDG perfusion PET: intraprocedural assessment of the liver tumor ablation margin
F-18 FDG perfusion PET: intraprocedural assessment of the liver tumor ablation margin
复制标题
DOI：
10.1007/s00261-021-02970-8
复制
发表时间：
2021-02-19
影响因子：
2.4
通讯作者：
Silverman, Stuart G.
中科院分区：
文献类型：
--
作者：
Shyn, Paul B.;Cubre, Alan J.;Silverman, Stuart G.
目的评价18氟脱氧葡萄糖（FDG）PET/CT引导下肝肿瘤微波消融术中的FDG灌注PET，以评估消融边缘并将最小边缘测量值与局部进展相关联。方法这项IRB批准的、符合HIPAA的研究包括20例接受FDG PET/CT引导的肝脏微波消融治疗31例FDG-avid肿瘤的成人患者（11例男性，9例女性;平均年龄65岁）。术中进行FDG灌注PET以评估消融边缘。记录关于重叠消融的术中决定。两名阅片者回顾性解释了术中灌注PET和术后对比增强MRI。记录消融边缘和最小边缘测量值的可评估性。局部进展的影像学随访时间为30 - 574天（平均310天）。进行最小边缘测量的回归建模。计算风险比，以将5 mm的消融边缘阈值与结局相关联。结果术中灌注PET提示对两个肿瘤进行了额外的重叠消融，两个肿瘤均未进展。8/31例（26%）肿瘤发生不完全消融或局部进展。重复消融后，次要有效性为26/31（84%）。两名研究阅片人均认为，使用灌注PET比MRI更常可完全评估消融边界（OR 69.7; CI 6.0，806.6; p = 0.001）。两名研究读片者认为，灌注PET上的最小消融边缘>= 5 mm与不完全消融/局部进展的低风险相关（HR 0.08和0.02，p < 0.001）。结论术中FDG灌注PET可持续评估肝脏肿瘤微波消融边缘，灌注PET最小消融边缘测量值与局部结局相关性良好。
Purpose To evaluate F-18-fluorodeoxyglucose (FDG) perfusion PET during FDG PET/CT-guided liver tumor microwave ablation procedures for assessing the ablation margin and correlating minimum margin measurements with local progression. Methods This IRB-approved, HIPAA-compliant study included 20 adult patients (11 M, 9 F; mean age 65) undergoing FDG PET/CT-guided liver microwave ablation to treat 31 FDG-avid tumors. Intraprocedural FDG perfusion PET was performed to assess the ablation margin. Intraprocedural decisions regarding overlapping ablations were recorded. Two readers retrospectively interpreted intraprocedural perfusion PET and postprocedural contrast-enhanced MRI. Assessability of the ablation margin and minimum margin measurements were recorded. Imaging follow-up for local progression ranged from 30 to 574 days (mean 310). Regression modeling of minimum margin measurements was performed. Hazard ratios were calculated to correlate an ablation margin threshold of 5 mm with outcomes. Results Intraprocedural perfusion PET prompted additional overlapping ablations of two tumors, neither of which progressed. Incomplete ablation or local progression occurred in 8/31 (26%) tumors. With repeat ablation, secondary efficacy was 26 (84%) of 31. Both study readers deemed ablation margins fully assessable more often using perfusion PET than MRI (OR 69.7; CI 6.0, 806.6; p = 0.001). Minimum ablation margins >= 5 mm on perfusion PET correlated with a low risk of incomplete ablation/local progression by both study readers (HR 0.08 and 0.02, p < 0.001). Conclusion Intraprocedural FDG perfusion PET consistently enabled complete liver tumor microwave ablation margin assessments, and the perfusion PET minimum ablation margin measurements correlated well with local outcomes.