3′-Deoxy-3′-[18F]-fluorothymidine PET/CT in early determination of prognosis in patients with esophageal squamous cell cancer
3′-Deoxy-3′-[18F]-fluorothymidine PET/CT in early determination of prognosis in patients with esophageal squamous cell cancer
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DOI：
10.1007/s00066-014-0744-8
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发表时间：
2015-02-01
影响因子：
3.1
通讯作者：
An, Hanxiang
中科院分区：
文献类型：
--
作者：
Chen, Haojun;Li, Yimin;An, Hanxiang
目的探讨3 '-脱氧-3'-[F-18]-氟胸苷早期反应分析的预后价值（F-18-FLT）PET/CT在食管鳞癌患者中的应用及与[F-18]-氟脱氧葡萄糖的比较（F-18-FDG）PET/CT.患者和材料对于34名食管鳞状细胞癌患者，在基线（术前）进行F-18-FLT PET/CT和F-18-FDG PET/CT扫描，放疗或放化疗开始后4周（中期）和治疗完成后2周（最终）。SUV（最大值）1、SUV（最大值）2和SUV（最大值）3分别代表术前、中期和最终扫描时测量的SUVmax（SUV：标准摄取值）。在术前和中期扫描时测量GTV（FLT-PET）和GTV（FDG-PET）（GTV：大体肿瘤体积）。Δ SUV/Δ GTV代表两个不同时间点之间SUVmax/GTV的分数变化。评估PET参数与结局的相关性。结果关于F-18-FLT PET/CT，根据受试者操作特征（ROC）曲线分析，预测2年无进展生存期（PFS）和局部控制（LRC）的参数显示最高的曲线下面积（AUC）在中期F-18-FLT PET/CT扫描中（Delta SUV 12，PFS的AUC为0.812，LRC的AUC为0.775，临界值为60%; P = 0.008），与术前和最终扫描的参数相比。Delta SUV 12大于60%的患者被定义为中期PET阴性组，其2年PFS和LRC优于中期PET阳性组（PFS：70.6% vs 35.2%，P = 0.025; LRC：84.2% vs 52.9，P = 0.046）。在F-18-FDG PET/CT方面，最终18 F-FDG PET/CT扫描的Delta SUV 13显示出比术前和中期扫描参数更好的预测（PFS的AUC为0.812，LRC为0.807，临界值为75%; P = 0.016）。最终F-18-FDG PET/CT扫描时SUVmax降低≥ 75%与更好的临床结局相关（PFS：73.3% vs 36.8%，P = 0.022; LRC：86.7% vs 52.6，P = 0.029）。结论早期中期F-18-FLT PET/CT是食管鳞癌患者2年PFS和LRC的重要预测因子，与早期缓解和晚期结局的相关性优于中期F-18-FDG PET/CT。
Purpose The purpose of this work was to investigate the prognostic value of response analysis using early 3'-deoxy-3'-[F-18]-fluorothymidine (F-18-FLT) PET/CT in esophageal squamous cancer patients and make a comparison with [F-18]-fluorodeoxyglucose (F-18-FDG) PET/CT.Patients and materials For 34 patients with esophageal squamous cell cancer, both F-18-FLT PET/CT and F-18-FDG PET/CT scans were performed at baseline (pre), 4 weeks after the start of radiotherapy or chemoradiotherapy (interim), and 2 weeks after therapy completion (final). SUV(max)1, SUV(max)2, and SUV(max)3 represent SUVmax (SUV: standard uptake values) measured on the pre, interim, and final scans, respectively. GTV(FLT-PET) and GTV(FDG-PET) (GTV: gross tumor volume) were measured on the pre and interim scans. Delta SUV/Delta GTV represents the fractional changes of SUVmax/GTV between two different time points. PET parameters were evaluated for correlations with outcome.Results Regarding F-18-FLT PET/CT, according to receiver operating characteristic (ROC) curve analysis, parameters for predicting 2-year progression-free survival (PFS) and locoregional control (LRC) showed the highest area under curve (AUC) on interim F-18-FLT PET/CT scans (Delta SUV12, AUC of 0.812 for PFS, 0.775 for LRC, with a cutoff of 60 %; P = 0.008), compared with the parameters on pre and final scans. Patients with a Delta SUV12 greater than 60 %, who were defined as interim PET-negative group, were associated with better 2-year PFS and LRC than the interim PET-positive group (PFS: 70.6 % vs. 35.2 %, P = 0.025; LRC: 84.2 % vs 52.9, P = 0.046). In terms of F-18-FDG PET/CT, Delta SUV13 on the final 18F-FDG PET/CT scan demonstrated better prediction (AUC of 0.812 for PFS, 0.807 for LRC, with a cutoff of 75 %; P = 0.016) than the parameters on pre and interim scans. An SUVmax decrease >= 75 % on the final F-18-FDG PET/CT scan was associated with better clinical outcome (PFS: 73.3 % vs. 36.8 %, P = 0.022; LRC: 86.7 % vs 52.6, P = 0.029). These correlations were most prominent in the subgroup of patients treated with chemoradiotherapy.Conclusion Early interim F-18-FLT PET/CT is a significant predictor of 2-year PFS and LRC, which is correlated better with early responses and late outcomes than interim F-18-FDG PET/CT in esophageal squamous cancer patients.