11c -蛋氨酸PET/CT对幕上胶质瘤复发的诊断价值

中华核医学与分子影像杂志 Pub Date : 2019-11-25 DOI:10.3760/CMA.J.ISSN.2095-2848.2019.11.002

Qiao Zhen, Zhao Xiaobin, C. Qian, Wang Kai, Fan Di, Ai Lin

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The maximum and mean standardized uptake value (SUVmax and SUVmean), tumor-to-background ratios (TBR) of SUVmax and SUVmean (TBRmax and TBRmean) were recorded and compared between patients with recurrence or without recurrence using independent-sample t test. Receiver operating characteristic (ROC) curves were drawn to determine the threshold, and the diagnostic sensitivity and specificity of each parameter were calculated. \n \n \nResults \nAccording to the clinical diagnosis, there were 139 patients with recurrence and 25 without recurrence. SUVmax, SUVmean, TBRmax and TBRmean were significantly higher for patients with recurrence than those without recurrence (4.19±1.95 vs 2.59±1.18, 2.34±1.08 vs 1.46±0.72, 2.95±1.17 vs 1.83±0.79, 2.64±1.11 vs 1.59±0.71; t values: 5.126-6.183, all P 0.05), for which the optimal cut-off values were 3.05, 1.65, 1.96 and 1.79, respectively, and the corresponding sensitivities/specificities for the diagnosis of recurrence were 67.6%(94/139)/100%(25/25), 67.6%(94/139)/100%(25/25), 79.9%(111/139)/100%(25/25), 74.8%(104/139)/100%(25/25), respectively. Patients with (n=81) or without (n=13) recurrence had different semiquantitative parameters in high-grade glioma group (t values: 5.137-5.871, all P 0.05). Among 37 patients with recurrence confirmed by pathology, there were no significant differences in the semiquantitative parameters between the high-grade and low-grade glioma groups and AUCs were not different either (t values: 1.387-1.937, z values: 0.106-1.752, all P>0.05). \n \n \nConclusions \nSemiquantitative parameters of 11C-MET PET/CT are equally accurate in the differentiation of recurrence from radiation injury in patients with gliomas, while TBRmean was superior than SUVmean in patients with the high-grade gliomas. 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引用次数: 0

摘要

目的评价11C-甲硫氨酸（MET）PET/CT半定量参数对幕上胶质瘤切除后经MRI诊断为可疑复发的患者复发的诊断价值。方法选择2015年6月至2017年6月在北京天坛医院接受11C-MET PET/CT检查的幕上胶质瘤患者164例（男107例，女57例，年龄6-74岁；高级别94例，低级别63例，不清楚7例）。所有患者术后均出现可疑复发，经MRI检查，随访至少6个月。通过组织病理学分析或临床随访来确定最终诊断。使用独立样本t检验记录复发或无复发患者的最大和平均标准化摄取值（SUVmax和SUVmean）、SUVmax的肿瘤背景比（TBRmax和TBRmean），并进行比较。绘制受试者工作特性（ROC）曲线以确定阈值，并计算每个参数的诊断敏感性和特异性。结果根据临床诊断，复发139例，无复发25例。复发患者的SUVmax、SUVmean、TBRmax和TBRmean显著高于无复发患者（4.19±1.95 vs 2.59±1.18、2.34±1.08 vs 1.46±0.72、2.95±1.17 vs 1.83±0.79、2.64±1.11 vs 1.59±0.71；t值：5.126-1.83，均P 0.05），其最佳截止值分别为3.05、1.65、1.96和1.79，诊断复发的敏感性/特异性分别为67.6%（94/139）/100%（25/25）、67.6%（94.139）/100%、79.9%（111/139）/100%（25/5）、74.8%（104/139）/100%（25/25。高级别胶质瘤组复发（n=81）和无复发（n=13）患者的半定量参数不同（t值：5.137-5.871，均P＜0.05），高级别和低级别胶质瘤组的半定量参数无显著差异，AUCs也无差异（t值1.387-1.937，z值0.106-1.752，均P>0.05），而在高级别胶质瘤患者中TBRmean优于SUVmean。在经病理证实复发的患者中，半定量参数对高、低级别胶质瘤的鉴别价值有限。关键词：胶质瘤；幕上肿瘤；肿瘤复发，局部；正电子发射断层扫描；层析成像，X射线计算机；蛋氨酸

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Diagnostic value of 11C-methionine PET/CT imaging for detecting the recurrence of supratentorial glioma

Objective To assess the diagnostic values of 11C-methionine (MET) PET/CT semiquantitative parameters for detecting recurrence in patients who were diagnosed with suspicious recurrence by MRI after resection of supratentorial gliomas. Methods A total of 164 patients (107 males, 57 females, age 6-74 years; high-grade 94, low-grade 63, unclear 7) with supratentorial gliomas who underwent 11C-MET PET/CT between June 2015 and June 2017 in Beijing Tiantan Hospital were enrolled respectively. All patients were with suspicious recurrence after surgery showed by MRI and followed up for 6 months at least. The final diagnosis was determined with histopathological analysis or clinical follow-up. The maximum and mean standardized uptake value (SUVmax and SUVmean), tumor-to-background ratios (TBR) of SUVmax and SUVmean (TBRmax and TBRmean) were recorded and compared between patients with recurrence or without recurrence using independent-sample t test. Receiver operating characteristic (ROC) curves were drawn to determine the threshold, and the diagnostic sensitivity and specificity of each parameter were calculated. Results According to the clinical diagnosis, there were 139 patients with recurrence and 25 without recurrence. SUVmax, SUVmean, TBRmax and TBRmean were significantly higher for patients with recurrence than those without recurrence (4.19±1.95 vs 2.59±1.18, 2.34±1.08 vs 1.46±0.72, 2.95±1.17 vs 1.83±0.79, 2.64±1.11 vs 1.59±0.71; t values: 5.126-6.183, all P 0.05), for which the optimal cut-off values were 3.05, 1.65, 1.96 and 1.79, respectively, and the corresponding sensitivities/specificities for the diagnosis of recurrence were 67.6%(94/139)/100%(25/25), 67.6%(94/139)/100%(25/25), 79.9%(111/139)/100%(25/25), 74.8%(104/139)/100%(25/25), respectively. Patients with (n=81) or without (n=13) recurrence had different semiquantitative parameters in high-grade glioma group (t values: 5.137-5.871, all P 0.05). Among 37 patients with recurrence confirmed by pathology, there were no significant differences in the semiquantitative parameters between the high-grade and low-grade glioma groups and AUCs were not different either (t values: 1.387-1.937, z values: 0.106-1.752, all P>0.05). Conclusions Semiquantitative parameters of 11C-MET PET/CT are equally accurate in the differentiation of recurrence from radiation injury in patients with gliomas, while TBRmean was superior than SUVmean in patients with the high-grade gliomas. Among the patients with recurrence confirmed by pathology, the value of the semiquantitative parameter is limited for the identification of high- and low- grade gliomas. Key words: Glioma; Supratentorial neoplasms; Neoplasm recurrence, local; Positron-emission tomography; Tomography, X-ray computed; Methionine

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来源期刊

中华核医学与分子影像杂志核医学，分子影像

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5088

期刊介绍： Chinese Journal of Nuclear Medicine and Molecular Imaging (CJNMMI) was established in 1981, with the name of Chinese Journal of Nuclear Medicine, and renamed in 2012. As the specialized periodical in the domain of nuclear medicine in China, the aim of Chinese Journal of Nuclear Medicine and Molecular Imaging is to develop nuclear medicine sciences, push forward nuclear medicine education and basic construction, foster qualified personnel training and academic exchanges, and popularize related knowledge and raising public awareness. Topics of interest for Chinese Journal of Nuclear Medicine and Molecular Imaging include: -Research and commentary on nuclear medicine and molecular imaging with significant implications for disease diagnosis and treatment -Investigative studies of heart, brain imaging and tumor positioning -Perspectives and reviews on research topics that discuss the implications of findings from the basic science and clinical practice of nuclear medicine and molecular imaging - Nuclear medicine education and personnel training - Topics of interest for nuclear medicine and molecular imaging include subject coverage diseases such as cardiovascular diseases, cancer, Alzheimer’s disease, and Parkinson’s disease, and also radionuclide therapy, radiomics, molecular probes and related translational research.