基于2-[18F]-氟- d -葡萄糖（2-[18F]- fdg）正电子发射断层扫描/计算机断层扫描（PET/CT）代谢参数的多参数诊断模型对神经母细胞瘤和神经节神经母细胞瘤的预测价值

IF 1.9 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical radiology Pub Date : 2025-06-21 DOI:10.1016/j.crad.2025.106998

S.-Q. Li , G.-Y. Wang , J. Liu, Y. Kan, W. Wang, J.-G. Yang

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引用次数: 0

摘要

目的评价整合瘤内代谢异质性参数和临床参数的多参数诊断模型在神经母细胞瘤（NB）和神经节神经母细胞瘤（GNB）鉴别中的诊断价值。材料与方法本回顾性研究纳入107例（新生儿64例，新生儿43例）行2-[18F]-氟- d -葡萄糖正电子发射断层扫描/计算机断层扫描（2-[18F]- fdg PET/CT）。收集并分析原发病灶的基线特征、临床资料和代谢参数，包括峰值标准化摄取值、最大标准化摄取值、平均标准化摄取值、肿瘤代谢体积、病灶糖酵解总量、累积标准化摄取值-体积直方图（AUC-CSH）指数曲线下面积。采用受试者工作特征曲线曲线下面积评价模型和预测因子的诊断性能，采用综合歧视性改善、净重分类改善、德龙性能改善检验和临床效用评价决策曲线分析。结果在代谢参数中，AUC-CSH指数具有最高的诊断效能。多变量分析发现AUC-CSH指数、年龄和血清神经元特异性烯醇化酶水平是独立的预测因子。综合这些因素的多参数模型明显优于个体代谢参数，并通过决策曲线分析验证了其临床实用性。结论将2-[18F]- fdg PET/CT的肿瘤内代谢异质性参数与临床参数相结合，建立多参数诊断模型，可提高NB与GNB的诊断效能，具有临床应用价值。

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Predictive value of multiparametric diagnostic model based on 2-[18F]-fluoro-D-glucose (2-[18F]-FDG) positron emission tomography/computed tomography (PET/CT) metabolic parameters in differentiating between neuroblastoma and ganglioneuroblastoma

Aim

To evaluate the diagnostic performance of a multiparametric diagnostic model integrating intratumoral metabolic heterogeneity parameter and clinical parameters for differentiating neuroblastoma (NB) from ganglioneuroblastoma (GNB).

Materials and Methods

This retrospective study included 107 patients (64 NB and 43 GNB) who underwent 2-[¹⁸F]-fluoro-D-glucose positron emission tomography/computed tomography (2-[¹⁸F]-FDG PET/CT). Baseline characteristics, clinical data, and metabolic parameters of the primary lesions, including peak standardised uptake value, maximum standardised uptake value, mean standardised uptake value, tumour metabolic volume, total lesion glycolysis, and the area under the curve of a cumulative standardised uptake value-volume histogram (AUC-CSH) index, were collected and analysed. Diagnostic performance of the model and predictors was assessed using area under the curve of the receiver operating characteristic curve, with integrated discriminatory improvement, net reclassification improvement, Delong test for performance improvement, and decision curve analysis for clinical utility evaluation.

Results

Among the metabolic parameters, the AUC-CSH index demonstrated the highest diagnostic performance. Multivariate analysis identified the AUC-CSH index, age, and serum neuron-specific enolase level as independent predictors. The multiparametric model integrating these factors significantly outperformed individual metabolic parameters, and its clinical utility was validated by decision curve analysis.

Conclusion

A multiparametric diagnostic model integrating intratumoral metabolic heterogeneity parameter derived from 2-[¹⁸F]-FDG PET/CT with clinical parameters improves diagnostic performance for differentiating NB from GNB, offering potential for clinical application.

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来源期刊

Clinical radiology 医学-核医学

CiteScore

4.70

自引率

3.80%

发文量

528

审稿时长

76 days

期刊介绍： Clinical Radiology is published by Elsevier on behalf of The Royal College of Radiologists. Clinical Radiology is an International Journal bringing you original research, editorials and review articles on all aspects of diagnostic imaging, including: • Computed tomography • Magnetic resonance imaging • Ultrasonography • Digital radiology • Interventional radiology • Radiography • Nuclear medicine Papers on radiological protection, quality assurance, audit in radiology and matters relating to radiological training and education are also included. In addition, each issue contains correspondence, book reviews and notices of forthcoming events.