Clinical Utility of (18)F-FDG PET in Neuroendocrine Tumors Prior to Peptide Receptor Radionuclide Therapy: A Systematic Review and Meta-Analysis.
Clinical Utility of (18)F-FDG PET in Neuroendocrine Tumors Prior to Peptide Receptor Radionuclide Therapy: A Systematic Review and Meta-Analysis.
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DOI：
10.3390/cancers13081813
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发表时间：
2021-04-10
期刊：
影响因子：
5.2
通讯作者：
Daskalakis K
中科院分区：
文献类型：
--
作者：
Alevroudis E;Spei ME;Chatziioannou SN;Tsoli M;Wallin G;Kaltsas G;Daskalakis K
18f -氟脱氧葡萄糖正电子发射断层扫描（18F-FDG PET）的功能成像已发展成为多种临床环境中许多恶性肿瘤诊断和治疗的主要临床工具，可提供有关肿瘤行为和侵袭性的宝贵信息。在神经内分泌肿瘤（NETs）领域，分子成像和新型治疗药物靶向治疗的最新进展支持更适合患者的方法。尽管肽受体放射性核素治疗（PRRT）最近已成为进展性NETs的一种既定治疗方法，但在PRRT之前，18F-FDG PET在不同来源和级别的NETs患者中的作用仍有待确定。在此，我们通过系统回顾和meta分析对当代文献中现有证据进行了全面总结，表明在PRRT之前使用68ga - dota肽和18F-FDG进行双功能成像似乎是NET管理的有用工具，可以描绘肿瘤生长抑素受体表达和糖酵解代谢活性，并预测肿瘤反应和生存结果。在肽受体放射性核素治疗（PRRT）之前，18F-FDG PET在不同级别神经内分泌肿瘤（NETs）患者中的作用尚未得到充分阐明。我们旨在评估18F-FDG PET状态对接受PRRT的神经内分泌肿瘤（NET）患者的疾病控制率（DCR）、无进展生存期（PFS）和总生存期（OS）的影响。我们检索了截至2020年7月的MEDLINE、Embase、Cochrane Library和Web of Science数据库，并使用纽卡斯尔-渥太华量表（NOS）标准评估偏倚的质量/风险。共筛选了5091篇文章。在12项研究中，纳入了1492例不同来源net的独特患者。在PRRT开始前，18F-FDG PET状态为阴性的患者的DCR为91.9%，而18F-FDG PET状态为阳性的患者的DCR为74.2%(随机效应优势比（OR）： 4.85；95% ci: 2.27-10.36)。合并风险比（HR）校正分析证实，接受PRRT且PET阴性的NET患者PFS和OS较长（随机效应HR:2.45; 95% ci: 1.48-4.04和HR:2.25; 95% ci: 1.55-3.28）。总之，在给予PRRT之前进行18F-FDG PET成像似乎是NET患者预测肿瘤反应和生存结果的有用工具，并且肿瘤FDG摄取阴性与延长PFS和OS相关。
Functional imaging with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) has evolved into a major clinical tool in cancer diagnosis and management for many malignancies in diverse clinical settings, providing valuable information on tumor behavior and aggressiveness. In the field of neuroendocrine tumors (NETs), recent advances in molecular imaging and targeted treatments with novel theranostic agents favor a more patient-tailored approach. Although peptide receptor radionuclide therapy (PRRT) has recently become an established therapy for progressive NETs, the role of 18F-FDG PET prior to PRRT in patients with NETs of different origins and grades remains to be determined. Herein, we provide a comprehensive summary of available evidence in contemporary literature by means of a systematic review and meta-analysis, demonstrating that dual-functional imaging with 68Ga-DOTA-peptides and 18F-FDG prior to PRRT appears to be a useful tool in NET management by delineating tumor somatostatin receptor expression and glycolytic metabolic activity, and predicting tumor response and survival outcomes. The role of 18F-FDG PET in patients with variable grades of neuroendocrine tumors (NETs) prior to peptide receptor radionuclide therapy (PRRT) has not been adequately elucidated. We aimed to evaluate the impact of 18F-FDG PET status on disease control rate (DCR), progression-free survival (PFS), and overall survival (OS) in neuroendocrine tumor (NET) patients receiving PRRT. We searched the MEDLINE, Embase, Cochrane Library, and Web of Science databases up to July 2020 and used the Newcastle-Ottawa scale (NOS) criteria to assess quality/risk of bias. A total of 5091 articles were screened. In 12 studies, 1492 unique patients with NETs of different origins were included. The DCR for patients with negative 18F-FDG PET status prior to PRRT initiation was 91.9%, compared to 74.2% in patients with positive 18F-FDG PET status (random effects odds ratio (OR): 4.85; 95% CI: 2.27–10.36). Adjusted analysis of pooled hazard ratios (HRs) confirmed longer PFS and OS in NET patients receiving PRRT with negative 18F-FDG PET (random effects HR:2.45; 95%CIs: 1.48–4.04 and HR:2.25; 95% CIs:1.55–3.28, respectively). In conclusion, 18F-FDG PET imaging prior to PRRT administration appears to be a useful tool in NET patients to predict tumor response and survival outcomes and a negative FDG uptake of the tumor is associated with prolonged PFS and OS.
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9.3
作者：
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DOI：
10.1007/s00259-014-2906-4
发表时间：
2015-02-01
影响因子：
9.1
作者：
Kashyap, Raghava;Hofman, Michael S.;Hicks, Rodney J.
通讯作者：
Hicks, Rodney J.