Evaluation of several FDG PET parameters for prediction of soft tissue tumour grade at primary diagnosis and recurrence
Evaluation of several FDG PET parameters for prediction of soft tissue tumour grade at primary diagnosis and recurrence
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DOI：
10.1007/s00330-015-3654-y
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发表时间：
2015-08-01
影响因子：
5.9
通讯作者：
Hacker, Marcus
中科院分区：
文献类型：
--
作者：
Fendler, Wolfgang P.;Chalkidis, Rebecca P.;Hacker, Marcus
本研究评价了基于SUV的参数的诊断准确性，这些参数来自[（18）F]-2-氟-2-脱氧-D-葡萄糖正电子发射断层扫描（FDG-PET），以优化软组织肿瘤（STT）分级的无创预测。回顾性分析STT的发生率。组织学是肿瘤分级的参考标准。几个标准化摄取值（SUV）参数的绝对值和肿瘤/肝脏比值与肿瘤分级相关，初步诊断时SUVmax、SUVpeak、SUVmax/SUV肝脏和SUV peak/SUV肝脏与肿瘤分级相关性良好。SUV峰值（受试者工作特征下的面积，AUC-ROC：0.82）和SUV峰值/SUV肝脏（AUC-ROC：0.82）在低级别之间分离最好（WHO中度、1级肉瘤和低风险胃肠道间质瘤，GIST）和高级别（2/3级肉瘤和中/高危GIST）病变：SUV峰值/SUV肝脏的最佳阈值为2.4，这导致灵敏度为79%，特异性为81%。在疾病复发时，每个参数的AUC-ROC < 0.75。肿瘤SUV峰值至少为平均肝脏摄取的2.4倍，预示着高级别的组织病理学，在原发分期时具有良好的诊断准确性。在疾病复发时，FDG-PET不能可靠地区分高级别和低级别病变。几个SUV参数在初步诊断时准确地预测软组织肉瘤的级别。肿瘤与肝脏的比值与绝对SUV参数具有可比价值。SUV（峰值）/SUV（肝脏）> 2.4对高级别病变的敏感性为79%，特异性为81%。FDG PET不能可靠地指示高级别肉瘤。
This study evaluates the diagnostic accuracy of SUV-based parameters derived from [(18) F]-2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in order to optimize non-invasive prediction of soft tissue tumour (STT) grade.One hundred and twenty-nine lesions from 123 patients who underwent FDG-PET for primary staging (n = 79) or assessment of recurrence (n = 44) of STT were analyzed retrospectively. Histopathology was the reference standard for tumour grading. Absolute values and tumour-to-liver ratios of several standardized uptake value (SUV) parameters were correlated with tumour grading.At primary diagnosis SUVmax, SUVpeak, SUVmax/SUVliver and SUVpeak/SUVliver showed good correlation with tumour grade. SUVpeak (area under the receiver-operating-characteristic, AUC-ROC: 0.82) and SUVpeak/SUVliver (AUC-ROC: 0.82) separated best between low grade (WHO intermediate, grade 1 sarcoma, and low risk gastrointestinal stromal tumours, GISTs) and high grade (grade 2/3 sarcoma and intermediate/high risk GISTs) lesions: optimal threshold for SUVpeak/SUVliver was 2.4, which resulted in a sensitivity of 79 % and a specificity of 81 %. At disease recurrence, the AUC-ROC was < 0.75 for each parameter.A tumour SUVpeak of at least 2.4 fold mean liver uptake predicts high grade histopathology with good diagnostic accuracy at primary staging. At disease recurrence, FDG-PET does not reliably separate high and low grade lesions.aEuro cent Several SUV parameters accurately predict soft tissue sarcoma grade at primary diagnosis.aEuro cent Tumour-to-liver ratios are of comparable value to absolute SUV parameters.aEuro cent SUV (peak) /SUV (liver) > 2.4 had 79 % sensitivity and 81 % specificity for high grade lesions.aEuro cent At recurrence, FDG PET does not reliably indicate high grade sarcomas.