Prognostic Significance of Volumetric Parameters on Pretreatment FDG PET/CT in Patients With Hepatocellular Carcinoma Receiving Atezolizumab Plus Bevacizumab Therapy.

IF 9.6 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Clinical Nuclear Medicine Pub Date : 2025-06-01 Epub Date: 2025-04-21 DOI:10.1097/RLU.0000000000005896
Jeong Won Lee, Sang Mi Lee, Beodeul Kang, Jung Sun Kim, Chansik An, Hong Jae Chon, Su Jin Jang
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引用次数: 0

Abstract

Background: This study aimed to assess prognostic significance of FDG PET/CT parameters in predicting progression-free survival (PFS) and overall survival (OS) in patients with hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab therapy.

Patients and methods: We retrospectively enrolled 78 patients with HCC who underwent FDG PET/CT before atezolizumab plus bevacizumab therapy and identified intrahepatic target tumor lesions on pretreatment imaging studies. From PET/CT images, we measured SUVmax, tumor-to-normal liver uptake ratio, metabolic tumor volume, and total lesion glycolysis (TLG) for intrahepatic tumor lesions, as well as SUVmax for extrahepatic metastatic lesions (extrahepatic SUVmax).

Results: In comparisons of PET/CT parameters, patients with progressive disease demonstrated significantly higher TLG values than those achieving complete or partial response ( P < 0.05). In the multivariate survival analysis, TLG independently predicted both PFS ( P = 0.019) and OS ( P = 0.003). Metabolic tumor volume was significantly associated with OS alone ( P = 0.010), and extrahepatic SUVmax was significantly associated with only PFS ( P = 0.045). Patients with high TLG values experienced poorer PFS and OS than those with low TLG values ( P < 0.05).

Conclusions: TLG in intrahepatic HCC lesions was significantly associated with treatment response and served as an independent prognostic factor for PFS and OS. TLG could be a potential imaging biomarker for predicting clinical outcomes in patients with HCC receiving atezolizumab plus bevacizumab therapy.

体积参数对接受阿特唑单抗加贝伐单抗治疗的肝癌患者FDG PET/CT预处理的预后意义
背景:本研究旨在评估FDG PET/CT参数在预测阿特唑单抗联合贝伐单抗治疗的肝细胞癌(HCC)患者的无进展生存期(PFS)和总生存期(OS)方面的预后意义。患者和方法:我们回顾性地招募了78例HCC患者,他们在阿特唑单抗联合贝伐单抗治疗前接受了FDG PET/CT检查,并通过预处理成像研究确定了肝内靶肿瘤病变。从PET/CT图像中,我们测量了SUVmax,肿瘤与正常肝脏摄取比,代谢肿瘤体积,肝内肿瘤病变的总病灶糖酵解(TLG)以及肝外转移病变的SUVmax(肝外SUVmax)。结果:在PET/CT参数比较中,进展性疾病患者的TLG值明显高于完全缓解或部分缓解患者(P < 0.05)。在多变量生存分析中,TLG独立预测PFS (P = 0.019)和OS (P = 0.003)。代谢性肿瘤体积仅与OS相关(P = 0.010),肝外SUVmax仅与PFS相关(P = 0.045)。高TLG患者的PFS和OS较低TLG患者差(P < 0.05)。结论:肝内HCC病变的TLG与治疗反应显著相关,是PFS和OS的独立预后因素。TLG可能是一种潜在的成像生物标志物,用于预测HCC患者接受atezolizumab + bevacizumab治疗的临床结果。
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来源期刊
Clinical Nuclear Medicine
Clinical Nuclear Medicine 医学-核医学
CiteScore
2.90
自引率
31.10%
发文量
1113
审稿时长
2 months
期刊介绍: Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty. Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.
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