18F FDG-PET/CT analysis of spread through air spaces (STAS) in clinical stage I lung adenocarcinoma

18F FDG-PET/CT analysis of spread through air spaces (STAS) in clinical stage I lung adenocarcinoma
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DOI:
10.1007/s12149-022-01773-1
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发表时间:
2022-07-12
影响因子:
2.6
通讯作者:
Yamagami, Takuji
Yamagami, Takuji
中科院分区:
医学4区
文献类型:
--
作者:
Nishimori, Miki;Iwasa, Hitomi;Yamagami, Takuji

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目的探讨18氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDG-PET/CT)在预测临床I期肺腺癌气隙播散(STAS)中的应用价值。方法2020年4月至2022年1月,52例(55个病灶)临床I期肺腺癌患者接受手术治疗。根据是否存在STAS将病变分为两组。计算18F FDG-PET/CT参数,特别是最大标准化摄取值(SUVmax)、代谢肿瘤体积(MTV)和总病变糖酵解(TLG)。比较两组手术病理检查的SUVmax、MTV和TLG。进行受试者工作特征(ROC)曲线分析以确定临界值。结果STAS阳性19例(35%),阴性36例(36%)。根据STAS的存在,SUVmax检测到显著差异(5.21 [范围1.52-16.50] vs. 2.42 [范围0.74-11.80],p = 0.0040),但不是MTV(3.44 [范围0.65-24.36]对比2.95 [0.00-20.07],p = 0.20)和TLG(7.92 [范围0.93-47.82]对比5.63 [0.00-58.66],p = 0.14)。SUVmax的AUC值为0.74(95% CI 0.61-0.87),在临界值2.48时,灵敏度为89.5%,特异性为52.8%。结论SUVmax是预测I期肺腺癌STAS的较有价值的指标,而MTV和TLG则无此价值。
Objective The purpose of this retrospective study was to investigate the utility of F-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F FDG-PET/CT) to predict spread through air spaces (STAS) in clinical stage I lung adenocarcinoma. Methods Between April 2020 and January 2022, 52 patients (55 lesions) who underwent surgery for clinical stage I lung adenocarcinoma were enrolled. The lesions were divided into two groups according to the presence of STAS. 18F FDG-PET/CT parameters, specifically the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were calculated. The SUVmax, MTV, and TLG were compared between the two groups upon surgical pathological examination. Receiver operating characteristic (ROC) curve analysis was performed to identify a cut-off value. Results Nineteen lesions (35%) were positive for STAS and 36 lesions were negative for STAS. According to the presence of STAS, significant differences were detected in the SUVmax (5.21 [range 1.52-16.50] vs. 2.42 [range 0.74-11.80], p = 0.0040) but not MTV (3.44 [range 0.65-24.36] vs. 2.95 [0.00-20.07], p = 0.20) and TLG (7.92 [range 0.93-47.82] vs. 5.63 [0.00-58.66], p = 0.14). SUVmax had an AUC value of 0.74 (95% CI 0.61-0.87) with a sensitivity of 89.5% and specificity of 52.8% at a cut-off of 2.48. Conclusions SUVmax rather than MTV and TLG were shown to be valuable indices for the prediction of STAS in clinical stage I lung adenocarcinoma.