Valor de la PET/TC con [18F]FDG en el diagnóstico y grado histopatológico de los adenomas colorrectales incidentales

IF 1.6 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Revista Espanola De Medicina Nuclear E Imagen Molecular Pub Date : 2025-03-01 DOI:10.1016/j.remn.2024.500075

Z. Qi , K. Tang , X. Lu , Y. Zhu , N. Xu

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引用次数: 0

Abstract

Purpose

Colorectal adenomas (CRAs) are at a higher risk of progressing to colorectal cancer (CRC) as their histological grade increases. Herein, this study investigated the relationship between the maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose positron emission tomography-computed tomography ([¹⁸F]FDG PET/CT) and the histological grades of CRAs and constructed the optimal regression model for distinguishing between different histological grades.

Methods

This study retrospectively analyzed the data of 153 patients with CRAs who had colorectal [¹⁸F]FDG uptake incidentally found on PET/CT. The patients were categorized into low-grade intraepithelial neoplasia (LGIN) and high-grade intraepithelial neoplasia (HGIN) groups based on their histological grade. After the analysis of the relationship between SUVmax measured on preoperative [¹⁸F]FDG PET/CT scans and histological grades, receiver-operating characteristic (ROC) curves were analyzed to determine the optimal cut-off values for distinguishing between the two groups. Common clinical and pathological factors were included and subjected to univariate and multivariate logistic regression analyses to identify independent risk factors. A diagnostic model integrating SUVmax and several risk factors was developed with the multivariate logistic regression analysis.

Results

SUVmax was significantly different between the two groups (P < .001) and increased with an elevation in the malignancy degree. The area under the ROC curve (AUC) for identifying LGIN and HGIN was 0.796, and the AUC of the combination model was 0.822. Furthermore, SUVmax was an independent risk factor for distinguishing between different histological grades in pairwise comparisons.

Conclusion

The regression model involving SUVmax on [¹⁸F]FDG PET/CT can distinguish between histological grades of CRAs, which therefore can be used as a noninvasive tool for the accurate diagnosis of CRAs and assist in developing patient-specific treatment strategies before surgery.

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带[18F]FDG的PET/TC在结肠直肠腺瘤的诊断和组织病理学程度方面的价值

目的：结直肠腺瘤（CRAs）随着其组织学分级的增加，其发展为结直肠癌（CRC）的风险更高。本研究探讨了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）的最大标准化摄取值（SUVmax）与cra组织分级的关系，并构建了区分不同组织分级的最优回归模型。方法回顾性分析153例经PET/CT偶然发现结直肠FDG摄取的cra患者的资料[18F]。根据组织学分级将患者分为低级别上皮内瘤变（LGIN）组和高级别上皮内瘤变（HGIN）组。在分析术前[18F]FDG PET/CT扫描测量的SUVmax与组织学分级的关系后，分析受试者工作特征（ROC）曲线，以确定区分两组的最佳截止值。纳入常见的临床和病理因素，并进行单因素和多因素logistic回归分析，以确定独立的危险因素。通过多因素logistic回归分析，建立了SUVmax与多个危险因素的综合诊断模型。结果两组间suvmax差异有统计学意义(P <；.001)，并随恶性程度的升高而升高。识别LGIN和HGIN的ROC曲线下面积（AUC）为0.796，联合模型的AUC为0.822。此外，在两两比较中，SUVmax是区分不同组织学分级的独立危险因素。结论[18F]FDG PET/CT上涉及SUVmax的回归模型可区分cra的组织学分级，可作为准确诊断cra的无创工具，有助于术前制定患者特异性治疗策略。

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

Revista Espanola De Medicina Nuclear E Imagen Molecular RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

1.10

自引率

16.70%

发文量

审稿时长

24 days

期刊介绍： The Revista Española de Medicina Nuclear e Imagen Molecular (Spanish Journal of Nuclear Medicine and Molecular Imaging), was founded in 1982, and is the official journal of the Spanish Society of Nuclear Medicine and Molecular Imaging, which has more than 700 members. The Journal, which publishes 6 regular issues per year, has the promotion of research and continuing education in all fields of Nuclear Medicine as its main aim. For this, its principal sections are Originals, Clinical Notes, Images of Interest, and Special Collaboration articles.