Prognostic Predictive Value of Total Lesion Glycolysis From 18F-FDG PET/CT in Post-Surgical Patients With Epithelial Ovarian Cancer
Prognostic Predictive Value of Total Lesion Glycolysis From 18F-FDG PET/CT in Post-Surgical Patients With Epithelial Ovarian Cancer
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DOI：
10.1097/rlu.0b013e31829f57fa
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发表时间：
2013-09-01
影响因子：
10.6
通讯作者：
Zhang, Yongxue
中科院分区：
文献类型：
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作者：
Liao, Shanshan;Lan, Xiaoli;Zhang, Yongxue
目的：探讨从F-18-FDG PET/CT图像中分割恶性病变的最佳阈值方法，并评价总病变糖酵解对卵巢上皮癌术后患者预后的预测价值。方法：回顾分析47例经手术病理证实的卵巢上皮癌患者，术后行F-18-FDG PET/CT显像。术后随访4~89个月，平均26.6+19.8个月。采用3D面积生长算法、标准摄取值(SUV)2.5和背景法对每个病灶进行2个阈值分割。比较两组的发现率。然后用最佳阈值方法计算全身代谢肿瘤体积(WBMTV)和全身病变糖酵解(WBTLG)。用Cox比例风险回归分析和Kaplan-Meier生存分析评价SUVmax、WBMTV、WBTLG等病理变量对总生存率的预后意义。结果：47例患者的142个转移灶均经长期临床随访或病理证实。阈值SUV2.5和背景法的检出率分别为37.32%和96.48%，差异有统计学意义(P<；0.005)。多因素分析显示，WBTLG是影响预后的独立预测因素(HR 1.043，95%CI1.01~1.078，P=0.011)，其他因素均无统计学意义。生存分析还显示，随着WBTLG的增加，生存时间明显缩短(P<；0.001)。结论：在这组上皮性卵巢癌术后患者中，背景法比SUV=2.5法能分割出更多的恶性病变，该方法得到的WBTLG可作为独立的预后因素。
Purpose: The aim of this study was to determine an optimal threshold method for the segmentation of malignant lesions from F-18-FDG PET/CT images and to evaluate the prognostic value of the total lesion glycolysis in post-surgical patients with epithelial ovarian cancer.Methods: We retrospectively reviewed 47 patients with pathologically proven epithelial ovarian cancer who underwent F-18-FDG PET/CT imaging after surgery. The follow-up time was 26.6 +/- 19.8 months (ranged from 4 to 89 months). For each patient, every lesion was segmented by 2 thresholds with 3D-area growing algorithm, standard uptake value (SUV) 2.5, and background method. The detection rates were compared. The optimal threshold method was then used to calculate whole-body metabolic tumor volume (WBMTV) and whole-body total lesion glycolysis (WBTLG). The prognostic significance of SUVmax, WBMTV, WBTLG, and other pathological variables for overall survival were assessed by Cox proportional hazards regression analysis and Kaplan-Meier survival analysis.Results: A total of 142 metastatic lesions of 47 patients were confirmed by long-term clinical follow-up or pathological findings. The detection rates of the threshold SUV 2.5 and background methods were 37.32% (53/142) and 96.48% (137/142), respectively, which showed significant difference between the 2 methods (P < 0.005). In multivariate analysis, WBTLG, obtained from the background method, was an independent predictive factor associated with the prognosis (HR 1.043, 95% CI 1.01-1.078, P = 0.011), and none of the other factors had statistical association. Survival analysis also showed that the survival time was clearly shortened with WBTLG increasing (P < 0.001).Conclusions: In this group of post-surgery patients with epithelial ovarian cancer, the background method could segment much more malignant lesions than SUV = 2.5 method, and WBTLG, obtained from this method, could be used as an independent prognostic factor.