正电子发射断层扫描/磁共振成像在预测食管胃交界处腺癌患者生存中的预后价值。

IF 2.5 4区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Gustav Holm Schæbel, Helle Hjorth Johannesen, Johan Löfgren, Henrik Gutte, Lene Bæksgaard, Michael Patrick Achiam, Mohamed Belmouhand
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引用次数: 0

摘要

近年来,正电子发射断层扫描/磁共振成像(PET/MRI)在诊断方面的应用越来越重要。这项研究对先前的一项初步研究进行了为期五年的随访,该研究证明了PET/MRI预测食管胃交界腺癌(AEG)可切除性的可行性。我们的目的是评估这种成像方式是否可以进一步作为AEG患者生存的预后工具。方法:共纳入22例患者,其中17例接受手术治疗。所有患者均接受了三个系列的新辅助化疗(NT)。本随访研究回顾性分析了原始研究中原发性肿瘤的表观扩散系数(ADC)和标准摄取值(SUV)测量值与总生存率和复发率的相关性。ADC和SUV值在NT开始前测量,并在NT给药第一个周期的17-21天再次测量,并计算扫描之间的差异为∆SUVmax,∆ADCb0和∆ADCb50。使用实体瘤反应评价标准(RECIST)评估早期治疗反应。采用二元logistic回归评价ADC和SUV参数的预测值,生成受试者工作特征(ROC)曲线,确定灵敏度、特异性和曲线下面积(AUC)。结果:截至2022年1月7日,22例患者中有8例仍然存活。计算AUC以评估影像学参数与长期生存的关系:∆SUVmax: AUC = 0.74,敏感性87.5%,特异性62.5% (p = 0.037)。∆ADCb0: AUC = 0.62,敏感性85.7%,特异性57.1% (p = 0.400)。∆ADCb50: AUC = 0.78,敏感性78.6%,特异性85.7% (p = 0.011)。综合这三个参数得出的AUC为0.81,敏感性为78.6%,特异性为85.7% (p = 0.002)。单项测量结果为:SUVmax(前nt): AUC = 0.56,敏感性78.6%,特异性50% (p = 0.646)。SUVmax(nt后):AUC = 0.81,敏感性85.7%,特异性87.5% (p = 0.002)。ADCb0(pre-NT): AUC = 0.55,敏感性71.4%,特异性62.5% (p = 0.682)。ADCb0(nt后):AUC = 0.63,敏感性78.6%,特异性57.1% (p = 0.339)。ADCb50(nt前):AUC = 0.51,敏感性85.7%,特异性37.5% (p = 0.952)。ADCb50(nt后):AUC = 0.63,敏感性42.9%,特异性100% (p = 0.279)。RECIST组与生存状态无显著相关(p = 0.15)。结论:PET/MRI预测AEG患者的长期生存是可行的。当SUV和ADC参数结合使用时,以及单独使用后nt SUVmax时,auc达到最高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The prognostic value of positron emission tomography/magnetic resonance imaging in predicting survival in patients with adenocarcinoma of the esophagogastric junction.

Introduction: In recent years, the utility of positron emission tomography/magnetic resonance imaging (PET/MRI) has become increasingly significant in diagnostic settings. This study provides a five-year follow-up on a previous pilot study that demonstrated the feasibility of PET/MRI in predicting the resectability of adenocarcinoma of the esophagogastric junction (AEG). We aimed to evaluate whether this imaging modality could further serve as a prognostic tool for survival in AEG patients.

Methods: A total of 22 patients were included in the initial pilot study, with 17 of them undergoing surgery. All patients underwent three series of neo-adjuvant chemotherapy (NT). This follow-up study retrospectively analyzed the correlation between the apparent diffusion coefficient (ADC) and standard uptake value (SUV) measurements of the primary tumor from the original study with overall survival and recurrence. ADC and SUV values were measured prior to initiation of NT, and again 17-21 days into the first cycle of NT-administration, and the differences between the scans were calculated as ∆SUVmax, ∆ADCb0, and ∆ADCb50. Early treatment response was assessed using the Response Evaluation Criteria In Solid Tumors (RECIST). Binary logistic regression was employed to evaluate the predictive values of ADC and SUV parameters, and receiver operating characteristic (ROC) curves were generated to determine sensitivity, specificity, and area under the curve (AUC).

Results: As of January 7, 2022, 8 of the 22 patients were still alive. The AUC was calculated to assess the association of imaging parameters with long-term survival: ∆SUVmax: AUC = 0.74, sensitivity, 87.5%, specificity 62.5% (p = 0.037). ∆ADCb0: AUC = 0.62, sensitivity 85.7%, specificity 57.1% (p = 0.400). ∆ADCb50: AUC = 0.78, sensitivity 78.6%, specificity 85.7% (p = 0.011). Combining all three parameters yielded an AUC of 0.81, with a sensitivity of 78.6% and a specificity of 85.7% (p = 0.002). The results for individual measurements were: SUVmax(pre-NT): AUC = 0.56, sensitivity 78.6%, specificity 50% (p = 0.646). SUVmax(post-NT): AUC = 0.81, sensitivity 85.7%, specificity 87.5% (p = 0.002). ADCb0(pre-NT): AUC = 0.55, sensitivity 71.4%, specificity 62.5% (p = 0.682). ADCb0(post-NT): AUC = 0.63, sensitivity 78.6%, specificity 57.1% (p = 0.339). ADCb50(pre-NT): AUC = 0.51, sensitivity 85.7%, specificity 37.5% (p = 0.952). ADCb50(post-NT): AUC = 0.63, sensitivity 42.9%, specificity 100% (p = 0.279). No significant correlation was found between RECIST group and survival status (p = 0.15).

Conclusion: Our results indicate that PET/MRI is feasible for predicting long-term survival in AEG patients. The highest AUCs were achieved when combining SUV and ADC parameters, and when using post-NT SUVmax alone.

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来源期刊
Annals of Nuclear Medicine
Annals of Nuclear Medicine 医学-核医学
CiteScore
4.90
自引率
7.70%
发文量
111
审稿时长
4-8 weeks
期刊介绍: Annals of Nuclear Medicine is an official journal of the Japanese Society of Nuclear Medicine. It develops the appropriate application of radioactive substances and stable nuclides in the field of medicine. The journal promotes the exchange of ideas and information and research in nuclear medicine and includes the medical application of radionuclides and related subjects. It presents original articles, short communications, reviews and letters to the editor.
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