Predicting Tumor Recurrence with Early 18F-FDG PET-CT After Thermal and Non-Thermal Ablation.

IF 3.4 4区 医学 Q2 ONCOLOGY
Govindarajan Narayanan, Nicole T Gentile, Brian J Schiro, Ripal T Gandhi, Constantino S Peña, Susan van der Lei, Madelon Dijkstra
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Abstract

The purpose was to determine the ability of 18-fluorodeoxyglucose (18F-FDG) positron emission tomography-computed tomography (PET-CT) scans performed within 24 h of percutaneous image-guided ablation of primary and metastatic malignancies to predict ablation effectiveness and local tumor progression (LTP). This single-center retrospective review included patients who underwent image guided ablation (microwave ablation (MWA), cryoablation, or irreversible electroporation (IRE)) between August 2018 and February 2024 for primary and metastatic malignancies. The primary outcome measure encompassed correlating post-ablation 18F-FDG PET-CT findings with LTP development per tumor, assessed using the chi-square test. The secondary outcome measure was local tumor progression-free survival (LTPFS) per tumor, evaluated using the Kaplan-Meier survival curves, and potential confounders were identified in multivariable analysis utilizing Cox proportional hazards regression models. A total of 132 patients, who underwent 159 procedures for 224 tumors, were included. During follow-up, LTP developed in 120 out of 224 tumors (53.6%). The presence of residual nodular 18F-FDG avidity on PET-CT within 24 h after the ablation significantly correlated with the development of LTP at follow-up imaging (p < 0.001). The positive predictive value of nodular 18F-FDG avidity was 86.7%. In multivariable analysis, the hazard ratio (HR) for 18F-FDG avidity was 2.355 (95% CI 1.614-2.647; p < 0.001). The presence of 18F-FDG avidity on PET-CT within 24 h after the ablation was highly correlated with development of LTP and decreased LTPFS. The detection of residual tumor tissue may allow early re-treatments, especially in tumors with nodular uptake, contributing to increased LTPFS.

热消融和非热消融后早期18F-FDG PET-CT预测肿瘤复发。
目的是确定18-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)在经皮图像引导的原发性和转移性恶性肿瘤消融后24小时内进行扫描的能力,以预测消融效果和局部肿瘤进展(LTP)。这项单中心回顾性研究纳入了2018年8月至2024年2月期间接受图像引导消融(微波消融(MWA)、冷冻消融或不可逆电穿孔(IRE))治疗原发性和转移性恶性肿瘤的患者。主要结局指标包括消融后18F-FDG PET-CT结果与每个肿瘤LTP发展的相关性,使用卡方检验进行评估。次要结局指标是每个肿瘤的局部肿瘤无进展生存期(LTPFS),使用Kaplan-Meier生存曲线进行评估,并利用Cox比例风险回归模型进行多变量分析,确定潜在的混杂因素。共包括132名患者,他们接受了159次手术,治疗了224个肿瘤。在随访期间,224例肿瘤中有120例(53.6%)发生LTP。消融后24 h内PET-CT上残留结节性18F-FDG的存在与随访影像LTP的发生有显著相关性(p < 0.001)。结节性18F-FDG的阳性预测值为86.7%。在多变量分析中,18F-FDG贪婪的危险比(HR)为2.355 (95% CI 1.614-2.647; p < 0.001)。消融后24 h内PET-CT上18F-FDG的存在与LTP的发生及LTPFS的降低高度相关。残留肿瘤组织的检测可能允许早期再治疗,特别是在结节性摄取的肿瘤中,这有助于增加LTPFS。
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来源期刊
Current oncology
Current oncology ONCOLOGY-
CiteScore
3.30
自引率
7.70%
发文量
664
审稿时长
1 months
期刊介绍: Current Oncology is a peer-reviewed, Canadian-based and internationally respected journal. Current Oncology represents a multidisciplinary medium encompassing health care workers in the field of cancer therapy in Canada to report upon and to review progress in the management of this disease. We encourage submissions from all fields of cancer medicine, including radiation oncology, surgical oncology, medical oncology, pediatric oncology, pathology, and cancer rehabilitation and survivorship. Articles published in the journal typically contain information that is relevant directly to clinical oncology practice, and have clear potential for application to the current or future practice of cancer medicine.
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