Parametric images via dynamic 18F-fluorodeoxyglucose positron emission tomographic data acquisition in predicting midterm outcome of liver metastases secondary to gastrointestinal stromal tumours
Parametric images via dynamic 18F-fluorodeoxyglucose positron emission tomographic data acquisition in predicting midterm outcome of liver metastases secondary to gastrointestinal stromal tumours
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DOI：
10.1007/s00259-011-1776-2
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发表时间：
2011-07-01
影响因子：
9.1
通讯作者：
Strauss, Ludwig G.
中科院分区：
文献类型：
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作者：
Apostolopoulos, Dimitris J.;Dimitrakopoulou-Strauss, Antonia;Strauss, Ludwig G.
目的18氟脱氧葡萄糖正电子发射断层扫描（FDG PET）可能低估了胃肠道间质瘤（GIST）患者接受分子靶向药物治疗后的肿瘤组织活性。本研究的目的是探讨动态数据采集后生成的参数图像对于检测活动性肝转移的价值。方法该分析包括对34名接受伊马替尼或舒尼替尼治疗的GIST肝转移患者进行的65项动态FDG PET研究。通过专用软件使用时间-活性数据的基于体素的线性回归计算截距和斜率的参数图像。截距图像表示示踪剂的分布体积和其整体代谢周转率的斜率。对所有图像进行目视和半定量评估。在每次PET研究后12个月确定肝病状态。二分变量的视觉解释和各种定量参数进入线性判别analysis.Results的统计模型的斜率图像的视觉分析比标准的1小时FDG摄取评价（70.6比51.0%，P=0.016）在检测肝脏疾病进展的情况下（n=51）更敏感。特异性无差异。判别分析模型中所有变量的组合正确地将87.7%的病例分类为进行性或非进行性疾病。结论截距和斜率参数图像通过可视化分离和定量示踪剂摄取的灌注和磷酸化依赖部分，为FDG PET研究的解释增加了新的维度。在治疗的GIST患者中，将这些信息与1小时摄取数据相结合，可以更好地表征肝脏病变的疾病活动性。
Purpose F-18-Fluorodeoxyglucose positron emission tomography (FDG PET) may underestimate viable tumour tissue in patients with gastrointestinal stromal tumours (GIST) treated with molecular targeted agents. The aim of the present study was to investigate the value of parametric images generated after dynamic data acquisition for the detection of active liver metastases.Methods The analysis included 65 dynamic FDG PET studies in 34 patients with liver metastases from GIST who were treated with imatinib or sunitinib. Parametric images of intercept and slope were calculated by dedicated software using a voxel-based linear regression of time-activity data. Intercept images represent the tracer's distribution volume and the slope its overall metabolic turnover. All images were assessed visually and semi-quantitatively. Liver disease status was established 12 months after each PET study. Dichotomous variables of visual interpretation and various quantitative parameters were entered in a statistical model of linear discriminant analysis.Results Visual analysis of slope images was more sensitive than the standard 1-h FDG uptake evaluation (70.6 vs 51.0%, p=0.016) in detecting cases with liver disease progression (n=51). Specificity did not differ. Combination of all variables in the discriminant analysis model correctly classified 87.7% of cases as progressive or non-progressive disease. Sensitivity was raised to 88.2%.Conclusion Parametric images of intercept and slope add a new dimension to the interpretation of FDG PET studies, by isolating visually and quantifying the perfusion and phosphorylation-dependent part of tracer uptake. In treated GIST patients, integration of this information with the 1-h uptake data achieves better characterization of hepatic lesions with respect to disease activity.