18F-FDG PET/CT对肾细胞癌肉瘤样分化的诊断及预后价值

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

EJNMMI Research Pub Date : 2025-02-19 DOI:10.1186/s13550-025-01206-w

Ritai Na, Zhao Chen, Yongshun Liu, Qianrui Chen, Qi Yang, Yongkang Qiu, Tianyao Wang, Lele Song, Sitong Wu, Wenpeng Huang, Xinyao Sun, Shaozhong Xian, Lei Kang

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The maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were compared. Overall survival (OS) and disease-free survival (DFS) were analyzed. SUVmax, MTV, TLG, and SUVmean values were significantly higher in SDRCC compared to non-SDRCC (P < 0.05). Additionally, SUVmax, TLG, and SUVmean were significantly higher in HG-SDRCC compared to non-HG-SDRCC (P < 0.05). ROC curves revealed that SUVmax and SUVmean were effective for distinguishing HG-SDRCC from non-HG-SDRCC. The log-rank test identified SUVmax > 11, MTV > 95, TLG > 500, SUVmean > 5.2, invasion of peripheral tissue and/or organs, and metastasis as risk factors for SDRCC patients. 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引用次数: 0

摘要

背景：在肾细胞癌（RCC）患者中，肉瘤样分化是肿瘤的侵袭性去分化特征，与预后不良相关。本研究旨在评估18F-FDG PET/CT在预测RCC肉瘤样分化中的应用及其潜在的预后价值。结果：本回顾性研究评估了采用18F-FDG PET/CT分期的新诊断的肉瘤样分化肾细胞癌（SDRCC）患者。患者分为高级别肉瘤样分化RCC （HG-SDRCC）、低级别肉瘤样分化RCC （LG-SDRCC）和非肉瘤样分化RCC （non-SDRCC）。比较最大标准化摄取值（SUVmax）、平均标准化摄取值（SUVmean）、代谢肿瘤体积（MTV）和病灶糖酵解总量（TLG）。分析总生存期（OS）和无病生存期（DFS）。SDRCC患者的SUVmax、MTV、TLG和SUVmean值明显高于非SDRCC患者（p11、MTV bbb95、TLG bbb500、SUVmean bbb5.2、外周组织和/或器官的侵袭和转移是SDRCC患者的危险因素）。多因素Cox比例风险模型分析显示，TLG bbbb500是DFS较差的危险因素，SUVmax b>1和SUVmean bbbb5.2是OS较差的危险因素。结论：18F-FDG PET/CT能有效鉴别HG-SDRCC与侵袭性更强的恶性肿瘤。本研究建立的预后模型表明，代谢参数，特别是DFS的TLG和OS的SUVmax/SUVmean，比肉瘤样分化程度更能预测患者预后。

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Diagnostic and prognostic role of ¹⁸F-FDG PET/CT for sarcomatoid differentiation in renal cell carcinoma.

Background: Sarcomatoid differentiation is an invasive dedifferentiated feature of tumor and associated with poor prognosis in renal cell carcinoma (RCC) patients. This study aimed to evaluate the utility of ¹⁸F-FDG PET/CT in predicting sarcomatoid differentiation in RCC and its potential prognostic value.

Results: This retrospective study assessed newly diagnosed sarcomatoid differentiation renal cell carcinoma (SDRCC) patients who were staged using ¹⁸F-FDG PET/CT. Patients were categorized into high-grade sarcomatoid differentiation RCC (HG-SDRCC), low-grade sarcomatoid differentiation RCC (LG-SDRCC), and non-sarcomatoid differentiation RCC (non-SDRCC). The maximum standardized uptake value (SUVmax), mean standardized uptake value (SUVmean), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were compared. Overall survival (OS) and disease-free survival (DFS) were analyzed. SUVmax, MTV, TLG, and SUVmean values were significantly higher in SDRCC compared to non-SDRCC (P < 0.05). Additionally, SUVmax, TLG, and SUVmean were significantly higher in HG-SDRCC compared to non-HG-SDRCC (P < 0.05). ROC curves revealed that SUVmax and SUVmean were effective for distinguishing HG-SDRCC from non-HG-SDRCC. The log-rank test identified SUVmax > 11, MTV > 95, TLG > 500, SUVmean > 5.2, invasion of peripheral tissue and/or organs, and metastasis as risk factors for SDRCC patients. Multivariate Cox proportional hazards model analyses indicated that TLG > 500 was a risk factor for poor DFS, while SUVmax > 11 and SUVmean > 5.2 were risk factors for poor OS.

Conclusions: ¹⁸F-FDG PET/CT can effectively differentiate HG-SDRCC with more aggressive malignancy. The prognostic model developed in this study demonstrates that metabolic parameters, particularly TLG for DFS and SUVmax/SUVmean for OS, serve as more robust predictors of patient outcomes than the degree of sarcomatoid differentiation.

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.