Prospective study of ^99mTc-3PRGD₂ SPECT/CT diagnosing metastatic lymph nodes in esophageal squamous cell carcinoma.

IF 2.3 3区医学 Q3 ONCOLOGY

Thoracic Cancer Pub Date : 2024-09-01 Epub Date: 2024-08-14 DOI:10.1111/1759-7714.15421

Xiaojin Wang, Guichao Liu, Zhanyu Li, Jiyun Shi, Mingzhu Liang, Guining Fu, Liangzhan Lv, Shaolong Ju, Yin Wang, Wenhua Xu, Fan Wang, Qingdong Cao, Hong Shan

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Abstract

Background: Lymph node (LN) metastasis is a significant prognostic factor for esophageal squamous cell carcinoma (ESCC), and there are no satisfactory methods for accurately predicting metastatic LNs. The present study aimed to assess the efficacy of ^99mTc-3PRGD₂ single-photon emission computed tomography (SPECT)/computed tomography (CT) for diagnosing metastatic LNs in ESCC.

Methods: A total of 15 enrolled patients with ESCC underwent ^99mTc-3PRGD₂ SPECT/CT and 18F-fluorodeoxyglucose positron emission tomography-computed tomography (¹⁸F-FDG PET/CT) examinations preoperatively. High-definition bone carving reconstruction technology (HD-xSPECT Bone) was applied to quantitatively assess the LN's SUV_max via SPECT/CT. The two methods were compared for diagnosing metastatic LNs with pathology as the gold standard.

Results: Among 15 patients, 23 metastatic lymph node stations (mLNSs) were predicted by SPECT/CT, with a mean SUV_max of 2.71 ± 1.34, of which 15 were pathologically confirmed; 32 mLNSs were predicted by PET/CT with a mean SUV_max of 4.41 ± 4.02, of which 17 were pathologically confirmed. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SPECT/CT for diagnosing metastatic LNs were 62.50%, 91.30%, 85.34%, 65.22%, and 90.32%, respectively, and those of PET/CT were 70.83%, 83.70%, 81.03%, 53.13%, and 91.67%, respectively. There was no significant difference in sensitivity (p = 0.061) or specificity (p = 0.058) between the two methods. The AUC_SPECT/CT was 0.816 and the SUV_max threshold was 2.5.

Conclusion: ^99mTc-3PRGD₂ SPECT/CT might be an effective method for diagnosing metastatic LNs in ESCC, especially in combination with HD-xSPECT Bone. The diagnostic efficiency of this method was noninferior to that of ¹⁸F-FDG PET/CT. The SUV_max threshold of 2.5 showed the highest agreement with the pathology findings.

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99mTc-3PRGD2 SPECT/CT 诊断食管鳞状细胞癌转移淋巴结的前瞻性研究。

背景：淋巴结(LN)转移是食管鳞状细胞癌(ESCC)的一个重要预后因素，目前还没有令人满意的方法来准确预测转移性LN。本研究旨在评估99m锝-3PRGD2单光子发射计算机断层扫描（SPECT）/计算机断层扫描（CT）诊断ESCC转移性LN的有效性：共有15名ESCC患者在术前接受了99m锝-3PRGD2 SPECT/CT和18F-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）检查。应用高清骨雕刻重建技术（HD-xSPECT Bone）通过 SPECT/CT 定量评估 LN 的 SUVmax。以病理学为金标准，比较两种方法对转移性淋巴结的诊断结果：在15名患者中，SPECT/CT预测出23个转移性淋巴结站（mLNS），平均SUVmax为（2.71 ± 1.34），其中15个经病理证实；PET/CT预测出32个转移性淋巴结站（mLNS），平均SUVmax为（4.41 ± 4.02），其中17个经病理证实。SPECT/CT诊断转移性LN的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为62.50%、91.30%、85.34%、65.22%和90.32%，PET/CT的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为70.83%、83.70%、81.03%、53.13%和91.67%。两种方法的灵敏度（p = 0.061）和特异性（p = 0.058）无明显差异。结论：99m锝-3PRGD2 SPECT/CT 可能是诊断 ESCC 转移性 LN 的有效方法，尤其是与 HD-xSPECT 骨联合使用时。该方法的诊断效率不低于18F-FDG PET/CT。SUVmax阈值为2.5时与病理结果的一致性最高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.