Prediction of short-term survival in patients with advanced nonsmall cell lung cancer following chemotherapy based on 2-Deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography: A feasibility study
Prediction of short-term survival in patients with advanced nonsmall cell lung cancer following chemotherapy based on 2-Deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography: A feasibility study
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DOI：
10.1007/s11307-007-0103-6
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发表时间：
2007-09-01
影响因子：
3.1
通讯作者：
Strauss, Ludwig G.
中科院分区：
文献类型：
--
作者：
Dimitrakopoulou-Strauss, Antonia;Hoffmann, Martin;Strauss, Ludwig G.
简介：动态正电子发射断层扫描（PET）的研究与2-脱氧-2-[F-18]氟-D-葡萄糖（FDG）在晚期非小细胞肺癌（NSCLC）患者接受姑息化疗，以评估全动力学分析的影响，并评估其价值与短期或长期survival.Materials和方法：评估包括42个转移灶在14例NSCLC患者。所有患者均接受由长春瑞滨和奥沙利铂组成的联合化疗方案。生存数据作为PET数据的参考。所有患者在化疗开始前和第一周期开始后第15-21天进行检查。从动态PET研究中检索以下参数：标准化摄取值（SUV）、分形维数、计算k1、k2、k3、k4（单位：1/min）的二室模型、分数血容量和根据Patlak的FDG流入量，使用公式（k1 x k3）/（k2+k3）计算。我们使用两组分类，即基于中位生存时间（193天）作为截止值的短期和长期生存组。采用支持向量机（SVM）对两个预先定义的组进行分类。结果：观察到的生存时间为40 ~ 392天，中位生存时间为193天。大多数动力学参数在一个循环后仅表现出小的变化，大多数下降。所有动力学参数的变化与基于生存率的分类无关。第一项和第二项研究之间SUV的变化显著（p=0.006），但对短期或长期生存期的预测没有影响。基于SVM的分析显示，第一项研究的SUV和流入量以及第二项研究的SUV、流入量、k2和k4的组合在短期和长期生存之间的正确分类率（CCR）最高，CCR为95.2%。结果表明，在NSCLC中FDG动力学的完整动力学分析有助于将其分类为短期或长期生存，并可用于识别这些患者可能受益于这种姑息性化疗方案。
Introduction: Dynamic positron emission tomography (PET) studies with 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) were performed in patients with advanced nonsmall cell lung cancer (NSCLC) who received palliative chemotherapy to evaluate the impact of full kinetic analysis and assess its value with regard to short or long survival.Materials and Methods: The evaluation includes 42 metastatic lesions in 14 patients with NSCLC. All patients received a combined chemotherapeutic protocol consisting of vinorelbin and oxaliplatin. The survival data served as reference for the PET data. All patients were examined before onset of chemotherapy and on day 15-21 after onset of the first cycle. The following parameters were retrieved from the dynamic PET studies: standardized uptake value (SUV), fractal dimension, two-compartment model with computation of k1, k2, k3, k4 (unit: 1/min), the fractional blood volume, and the FDG-influx according to Patlak was calculated using the formula (k1 x k3)/(k2+k3). We used a two-group classification, namely, a short- and long-term survival group based on the median survival time (193 days) as a cutoff. A support vector machines (SVM) analysis was used for classification of the two a prior defined groups.Results: The observed survival times varied from 40 to 392 days with a median survival time of 193 days. Most kinetic parameters demonstrated only small changes mostly declining after one cycle. The change in all kinetic parameters did not correlate to the survival-based classification. The change in SUV was significant between the first and second study (p=0.006) but without an impact on the prediction of short or long survival. SVM-based analysis revealed the highest correct classification rate (CCR) between short and long survival for the combination of SUV and influx of the first study and SUV, influx, k2, and k4 of the second study with a CCR of 95.2%.Conclusions: The results demonstrate that a full kinetic analysis of the FDG kinetics in NSCLC is helpful for the classification into short or long survival and may be used to identify those patients who may benefit from this palliative chemotherapeutic protocol.