Changes in Cervical Cancer FDG Uptake During Chemoradiation and Association With Response
Changes in Cervical Cancer FDG Uptake During Chemoradiation and Association With Response
复制标题
DOI：
10.1016/j.ijrobp.2012.02.056
复制
发表时间：
2013-01-01
影响因子：
7
通讯作者：
Grigsby, Perry W.
中科院分区：
文献类型：
--
作者：
Kidd, Elizabeth A.;Thomas, Maria;Grigsby, Perry W.
目的：以往的研究表明，用最大标准摄取值(SUVmax)和摄取变异性(FDG(Hetero))来评估F-18氟脱氧葡萄糖(FDG)的治疗前摄取可预测宫颈癌患者的治疗后反应。在这项初步研究中，我们评估了宫颈癌同步放化疗过程中SUVmax和FDG(Hetero)的变化及其与治疗后反应的关系。方法和材料：25例Ib1-IVa期宫颈癌患者。治疗前、治疗2周和治疗4周时，通过FDG正电子发射断层扫描(PET/CT)记录SUVmax、FDG(Hetero)和代谢性肿瘤体积(MTV)，并在治疗后3个月评估SUVmax、FDG(Hetero)和代谢肿瘤体积(MTV)的变化及其与疗效的关系。结果：所有患者治疗前平均SUVmax为17.8，MTV为55.4 cm(3)，FDG(Hetero)为-1.33。与基线相比，第2周的SUVmax也有类似的下降，与第2周相比，第4周也有类似的下降(34%)。在系列扫描中，肿瘤中FDG摄取最高的区域保持相对一致。治疗过程中平均FDG(杂合度)下降。所有患者的MTV在第2~4周比治疗前至第2周下降更多。到第4周，平均SUVmax下降了57%，MTV下降了30%。5例患者在治疗后3个月的正电子发射计算机断层扫描(PET)上显示持续或新发疾病。这些较差的应答者在所有3次都表现出更高的平均SUVmax，更大的MTV，以及更大的异质性。4周SUVmax(P=0.037)、4周FDG(异源)(P=0.005)、治疗前MTV(P=0.008)和治疗前FDG(异源)(P=0.008)均与治疗后PET反应显著相关。结论：SUVmax在治疗过程中持续下降，且下降的速度快于MTV的恢复。根据这项初步研究，治疗前和治疗4周是预测反应的最佳时间点。(C)2013年爱思唯尔公司。
Purpose: Previous research showed that pretreatment uptake of F-18 fluorodeoxyglucose (FDG), as assessed by the maximal standardized uptake value (SUVmax) and the variability of uptake (FDG(hetero)), predicted for posttreatment response in cervical cancer. In this pilot study, we evaluated the changes in SUVmax and FDG(hetero) during concurrent chemoradiation for cervical cancer and their association with post-treatment response.Methods and Materials: Twenty-five patients with stage Ib1-IVa cervical cancer were enrolled. SUVmax, FDG(hetero), and metabolic tumor volume (MTV) were recorded from FDG-positron emission tomography (PET)/computed tomography (CT) scans performed pretreatment and during weeks 2 and 4 of treatment and were evaluated for changes and association with response assessed on 3-month post-treatment FDG-PET/CT.Results: For all patients, the average pretreatment SUVmax was 17.8, MTV was 55.4 cm(3), and FDG(hetero) was -1.33. A similar decline in SUVmax was seen at week 2 compared with baseline and week 4 compared with week 2 (34%). The areas of highest FDG uptake in the tumor remained relatively consistent on serial scans. Mean FDG(hetero) decreased during treatment. For all patients, MTV decreased more from week 2 to week 4 than from pretreatment to week 2. By week 4, the average SUVmax had decreased by 57% and the MTV had decreased by 30%. Five patients showed persistent or new disease on 3-month post-treatment PET. These poor responders showed a higher average SUVmax, larger MTV, and greater heterogeneity at all 3 times. Week 4 SUVmax (P=.037), week 4 FDG(hetero) (P=.005), pretreatment MTV (P=.008), and pretreatment FDG(hetero) (P=.008) were all significantly associated with posttreatment PET response.Conclusions: SUVmax shows a consistent rate of decline during treatment and declines at a faster rate than MTV regresses. Based on this pilot study, pretreatment and week 4 of treatment represent the best time points for prediction of response. (C) 2013 Elsevier Inc.