PET-Based Primary Tumor Volumetric Parameters and Survival of Patients With Non-Small Cell Lung Carcinoma
PET-Based Primary Tumor Volumetric Parameters and Survival of Patients With Non-Small Cell Lung Carcinoma
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DOI：
10.2214/ajr.12.9138
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发表时间：
2013-03-01
影响因子：
5
通讯作者：
Subramaniam, Rathan M.
中科院分区：
文献类型：
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作者：
Davison, Jessica;Mercier, Gustavo;Subramaniam, Rathan M.
目标。该研究的目的是评估原发肿瘤的代谢肿瘤体积和总糖酵解活性作为预测非小细胞肺癌(NSCLC)患者预后的指标。对39名在本机构接受过基线分期的非小细胞肺癌诊断的患者进行了回顾性分析。使用梯度法从PET中分割出最大标准摄取值(SUVmax)、代谢肿瘤体积和总糖酵解活性；以12个月生存期和随访结束时的总生存期作为结果指标。结果：死亡患者的平均基于梯度的代谢性肿瘤体积和基于梯度的总糖酵解活性(分别为93.3m L和597.5 g)显著高于存活患者(分别为19.3m L和193.9 g)(p<；0.003和p<；0.031)。存活12个月的患者(12.7个月)和死亡患者(13.1个月)之间的平均SUVmax差异无统计学意义(p=0.85)。在多变量分析中，当调整所有其他因素时，基于梯度的代谢肿瘤体积是唯一与12个月死亡率相关的变量。基于梯度的代谢性肿瘤体积的曲线下面积为0.77(p<；0.006)。以基于中位梯度的代谢肿瘤体积(9.7毫升)为切入点，高梯度和低梯度代谢性肿瘤体积(对数等级p<；0.05)队列之间的生存时间有显著差异。结论：基于PET的体积成像参数是预测非小细胞肺癌患者预后的潜在指标。
OBJECTIVE. The purpose of the study was to assess metabolic tumor volume and total glycolytic activity of the primary tumor as prognostic parameters for outcome in patients with non-small cell lung carcinoma (NSCLC).MATERIALS AND METHODS. Thirty-nine patients who had undergone a baseline staging PET/CT examination at our institution for the diagnosis of NSCLC were retrospectively identified. The maximum standardized uptake value (SUVmax), metabolic tumor volume, and total glycolytic activity were segmented from PET using the gradient method; 12-month survival and overall survival at the end of follow-up were used as outcome measures. Multivariate logistic regression, receiver operating characteristic curve analysis, and Kaplan-Meier curves for survival analysis were generated and compared using the Mantel-Cox log-rank test.RESULTS. The mean gradient-based metabolic tumor volume and gradient-based total glycolytic activity were significantly greater in the patients who died (93.3 mL and 597.5 g) than in those who survived (19.3 mL and 193.9 g, respectively) (p < 0.003 and p < 0.031). There was no statistically significant difference in the mean SUVmax between the patients who survived (12.7) at 12 months and those who had died (13.1) (p = 0.85). On multivariate analysis, gradient-based metabolic tumor volume was the only variable associated with 12-month mortality when adjusted for all other factors.. The area under the curve (AUC) for gradient-based metabolic tumor volume was 0.77 (p < 0.006). A significant difference in the time to survival was observed between high and low gradient-based metabolic tumor volume (log-rank p < 0.05) cohorts using the median gradient-based metabolic tumor volume (9.7 mL) as the cut point.CONCLUSION. PET-based volumetric imaging parameters are potential prognostic markers of outcome in patients with NSCLC.