Volume-Based F-18 FDG PET/CT Imaging Markers Provide Supplemental Prognostic Information to Histologic Grading in Patients With High-Grade Bone or Soft Tissue Sarcoma.
Volume-Based F-18 FDG PET/CT Imaging Markers Provide Supplemental Prognostic Information to Histologic Grading in Patients With High-Grade Bone or Soft Tissue Sarcoma.
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DOI：
10.1097/md.0000000000002319
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发表时间：
2015-12
期刊：
影响因子：
1.6
通讯作者：
Loft A
中科院分区：
文献类型：
--
作者：
Andersen KF;Fuglo HM;Rasmussen SH;Petersen MM;Loft A
本研究的目的是评估不同的基于体积的肿瘤代谢活性计算在使用F-18 FDG PET/CT对高级别骨肉瘤（BS）和软组织肉瘤（STS）患者进行初步评估中的预后价值。一项2002年至2012年的单中心回顾性研究，纳入了92例经组织学证实的高级别BS（N = 37）或STS（N = 55）患者。 所有患者均接受了治疗前F-18 FDG PET/CT扫描。登记临床数据。以原发肿瘤最大标准化摄取值的40%（MTV40%）和总病变糖酵解（TLG）作为预测变量，通过ROC曲线分析确定最佳区分临界值，测量代谢肿瘤体积的准确性。根据临界值对患者进行分组。所有死亡均被视为生存分析中的事件。采用Kaplan-Meier生存估计和对数秩检验比较生存分布的均匀程度。使用考克斯比例风险回归分析评估具有相关风险比（HR）的预后变量。92例患者中有41例在随访期间死亡（45%; 12例BS和29例STS）。入选患者的平均生存期为6.5年（95% CI 5.8-7.3年），5年生存率为52%。在所有患者和亚组分析中，TLG和MTV 40%作为预后变量的准确性很高。TLG的AUC高于MTV 40%。在所有纳入患者的多变量回归分析（P = 0.01，HR 4.78 [95% CI 1.45-15.87]）和亚组分析（BS：P = 0.04，HR 11.11 [95% CI 1.09-111.11]; STS：P <0.05，HR 3.37 [95% CI 1.02-11.11]）中，高于最佳临界值的TLG是唯一独立预后生存的变量。 MTV40%未显示显著结果。基于体积的F-18 FDG PET/CT成像标记物在治疗前TLG估计方面为组织学分级提供了补充预后信息，具有预测高级别BS或STS患者总生存率的显著独立特性。
The aim of the study is to assess the prognostic value of different volume-based calculations of tumor metabolic activity in the initial assessment of patients with high-grade bone sarcomas (BS) and soft tissue sarcomas (STS) using F-18 FDG PET/CT. A single-site, retrospective study from 2002 to 2012 including 92 patients with histologically verified high-grade BS (N = 37) or STS (N = 55). All patients underwent a pretreatment F-18 FDG PET/CT scan. Clinical data were registered. Measurements of the accuracy of metabolic tumor volume with a preset threshold of 40% of the maximum standardized uptake value of primary tumor (MTV40%) and total lesion glycolysis (TLG) as prognostic variables and identification of optimal discriminating cut-off values were performed through ROC curve analysis. Patients were grouped according to the cut-off values. All deaths were considered an event in survival analysis. Kaplan–Meier survival estimates and log-rank test were used to compare the degree of equality of survival distributions. Prognostic variables with related hazard ratios (HR) were assessed using Cox proportional hazards regression analysis. Forty-one of 92 patients died during follow-up (45%; 12 BS and 29 STS). Average survival for included patients was 6.5 years (95% CI 5.8–7.3 years) and probability of 5-year survival was 52%. There was a high-significant accuracy of TLG and MTV40% as prognostic variables when looking on all patients and during subgroup analysis. AUCs were higher for TLG than for MTV40%. TLG above optimal cut-off value was the only variable which was independently prognostic for survival throughout multivariate regression analysis of all included patients (P = 0.01, HR 4.78 [95% CI 1.45–15.87]) and subgroup analysis (BS: P = 0.04, HR 11.11 [95% CI 1.09–111.11]; STS: P < 0.05, HR 3.37 [95% CI 1.02–11.11]). No significant results were demonstrated for MTV40%. Volume-based F-18 FDG PET/CT imaging markers in terms of pretreatment estimation of TLG provide supplemental prognostic information to histologic grading, with significant independent properties for prediction of overall survival in patients with high-grade BS or STS.