The Impact of 18F-FDG PET/CT and Related Parameters on Staging, Disease Management and Prognosis in Patients with Cholangiocarcinoma.

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Fatih Tamer, Khayala Mammadli, Ülkem Yararbaş
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引用次数: 0

Abstract

Objectives: We aimed to evaluate the relationship of 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) parameters with diagnostic efficacy, disease management and prognosis in patients with cholangiocarcinoma (CCA). The prognostic value of the spleen/liver 18F-FDG uptake ratio was also investigated.

Methods: The clinical and imaging findings of 39 patients who met the diagnostic criteria and underwent 18F-FDG PET/CT imaging for staging between 2013 and 2023 were retrospectively analysed.

Results: The tumour was intrahepatic in 34 patients and extrahepatic in 5 patients. PET/CT detected nodal involvement in 21 patients (53.8%) and distant metastases in 35 patients (89.7%). Fourteen cases (35.9%) had regional-distant metastases detected by PET/CT but not by magnetic resonance imaging/CT, and the stage of the disease changed accordingly. SUVmax, SUVmean, metabolic tumor volume, tumour lesion glycolysis, tumor-to-liver ratio (tumour/liver parenchyma SUVmax), tumor-to-background ratio (tumour/blood pool SUVmax), tumor-stroma ratio (tumour/spleen parenchyma SUVmax), and standardized liver ratio (SLR) (spleen/liver SUVmax) did not differ based on tumour location. Recurrence occurred in 14 patients (35.9%), and 2 patients survived. When the cut-off values for the parameters were determined by the Youden index, progression-free survival (PFS) was significantly shorter in patients with an SLR value of less than 0.94 compared to the others (p=0.04). Nodal involvement, metastatic location, and other PET/CT parameters had no significant effect on PFS and overall survival.

Conclusion: Our results highlight the efficacy of 18F-FDG PET/CT in staging nodal and distant metastases, similar to several studies in patients with CCA. Although SLR was found to have significant efficacy in PFS among the parameters we analysed, it is appropriate to evaluate the prognostic significance of these parameters in larger patient groups.

18F-FDG PET/CT及相关参数对胆管癌患者分期、疾病管理及预后的影响
目的:探讨18氟-氟脱氧葡萄糖(18F-FDG)正电子发射断层扫描/计算机断层扫描(PET/CT)参数与胆管癌(CCA)患者诊断疗效、疾病管理及预后的关系。脾/肝18F-FDG摄取比的预后价值也进行了研究。方法:回顾性分析2013 - 2023年39例符合诊断标准并行18F-FDG PET/CT分期的患者的临床及影像学表现。结果:34例肿瘤位于肝内,5例位于肝外。PET/CT检测到21例(53.8%)淋巴结受累,35例(89.7%)远处转移。14例(35.9%)经PET/CT检出远处转移灶,而磁共振/CT未检出,其分期也随之改变。SUVmax、SUVmean、代谢肿瘤体积、肿瘤病变糖酵解、肿瘤与肝脏之比(肿瘤/肝实质SUVmax)、肿瘤与背景之比(肿瘤/血池SUVmax)、肿瘤与基质之比(肿瘤/脾实质SUVmax)、标准化肝脏之比(SLR)(脾脏/肝脏SUVmax)均不因肿瘤位置而异。复发14例(35.9%),存活2例。当参数的临界值由约登指数确定时,SLR值小于0.94的患者的无进展生存期(PFS)明显短于其他患者(p=0.04)。淋巴结受累、转移部位和其他PET/CT参数对PFS和总生存期没有显著影响。结论:我们的研究结果强调了18F-FDG PET/CT在分期淋巴结和远处转移中的有效性,与CCA患者的几项研究相似。虽然在我们分析的参数中发现SLR对PFS有显著的疗效,但在更大的患者群体中评估这些参数的预后意义是合适的。
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来源期刊
Molecular Imaging and Radionuclide Therapy
Molecular Imaging and Radionuclide Therapy RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.30
自引率
0.00%
发文量
50
期刊介绍: Molecular Imaging and Radionuclide Therapy (Mol Imaging Radionucl Ther, MIRT) is publishes original research articles, invited reviews, editorials, short communications, letters, consensus statements, guidelines and case reports with a literature review on the topic, in the field of molecular imaging, multimodality imaging, nuclear medicine, radionuclide therapy, radiopharmacy, medical physics, dosimetry and radiobiology.
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