11c -蛋氨酸PET/CT和MRI对弥漫性脑干胶质瘤患者预后的价值

Q4 Medicine

中华神经外科杂志 Pub Date : 2019-09-28 DOI:10.3760/CMA.J.ISSN.1001-2346.2019.09.010

Xiaobin Zhao, Kai Wang, Lu Kong, Deling Li, Yuliang Wu, Ya-ming Wang, Z. Qiao, Qian Chen, L. Ai, Liwei Zhang

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Within 2 weeks after imaging, 33 patients underwent tumor resection, and the remaining 8 underwent stereotactic biopsy. Postoperative radiotherapy and/or chemotherapy were performed in 27 patients. Cox regression analysis was used to analyze the effects of MET-PET/CT and MRI measurements on the overall survival (OS) of DIPG patients. \n \n \nResults \nOf the 41 patients, 24 (58.5%) FLAIR hyperintensity and 39 (95.1%) MRI enhancement presented and all (100.0%) MET-PET/CT uptake increased. The median follow-up time of 41 patients was 9 months (1-27months). The median survival time was 14.4 months (12.0-16.7 months). At the end of follow-up, 20 patients survived and 21 died. Univariate prognostic analysis discovered that age 18 or older and adjuvant therapy were prognostic protective factors, while EV, SUVmax, SUVmean and tumor grade were prognostic risk factors (all P<0.05). 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引用次数: 0

摘要

目的探讨11c -蛋氨酸正电子发射断层扫描/CT (MET-PET/CT)联合MRI对弥漫性内生性脑桥胶质瘤(DIPG)患者的预后价值。方法前瞻性纳入2016年3月至2017年6月首都医科大学附属北京天坛医院神经外科收治的临床疑似DIPG患者41例，分别行MET-PET/CT扫描和脑MRI检查。MET-PET/CT测量包括肿瘤代谢体积(MTV)、最大标准化摄取值(SUVmax)和平均标准化摄取值(SUVmean)， MRI增强体积(EV)和FLAIR显示体积(FV)。还计算了EV/MTV值以供分析。成像后2周内，33例患者行肿瘤切除术，其余8例行立体定向活检。27例患者术后接受放疗和/或化疗。采用Cox回归分析MET-PET/CT和MRI测量对DIPG患者总生存期(OS)的影响。结果41例患者中，FLAIR高信号24例(58.5%)，MRI增强39例(95.1%)，MET-PET/CT摄取均增加(100.0%)。41例患者中位随访时间为9个月(1 ~ 27个月)。中位生存时间为14.4个月(12.0 ~ 16.7个月)。随访结束时，存活20例，死亡21例。单因素预后分析发现，年龄≥18岁和辅助治疗是预后保护因素，而EV、SUVmax、SUVmean和肿瘤分级是预后危险因素(均P<0.05)。多因素分析显示，EV (HR=2.983, 95%CI: 1.074 ~ 8.284, P=0.036)、肿瘤分级(HR=7.568, 95%CI: 2.029 ~ 28.229, P=0.003)、辅助治疗(HR=0.212, 95%CI: 0.078 ~ 0.582, P=0.003)为独立预后因素。结论MET-PET/CT联合MR可以预测DIPG患者的预后。关键词:脑干肿瘤;神经胶质瘤;正电子发射断层扫描;11 c -蛋氨酸

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Prognostic value of 11C-methionine PET/CT and MRI in diffuse intrinsic brain stem glioma patients

Objective To explore the prognostic value of 11C-methionine positron emission tomography/CT (MET-PET/CT) combined with MRI in patients with diffuse intrinsic pontine glioma (DIPG). Methods A total of 41 patients clinically suspicious of DIPG admitted to Department of Neurosurgery of Beijing Tiantan Hospital, Capital Medical University from March 2016 to June 2017 were prospectively included and underwent MET-PET/CT scan and brain MRI. The measurements on MET-PET/CT included tumor metabolic volume (MTV), maximum standardized uptake value (SUVmax) and mean standardized uptake value (SUVmean), while those on MRI enhancement volume (EV) and FLAIR displayed volume (FV). The EV/MTV values were also calculated for analysis. Within 2 weeks after imaging, 33 patients underwent tumor resection, and the remaining 8 underwent stereotactic biopsy. Postoperative radiotherapy and/or chemotherapy were performed in 27 patients. Cox regression analysis was used to analyze the effects of MET-PET/CT and MRI measurements on the overall survival (OS) of DIPG patients. Results Of the 41 patients, 24 (58.5%) FLAIR hyperintensity and 39 (95.1%) MRI enhancement presented and all (100.0%) MET-PET/CT uptake increased. The median follow-up time of 41 patients was 9 months (1-27months). The median survival time was 14.4 months (12.0-16.7 months). At the end of follow-up, 20 patients survived and 21 died. Univariate prognostic analysis discovered that age 18 or older and adjuvant therapy were prognostic protective factors, while EV, SUVmax, SUVmean and tumor grade were prognostic risk factors (all P<0.05). Multivariate analysis showed that EV (HR=2.983, 95%CI: 1.074-8.284, P=0.036), tumor grade (HR=7.568, 95% CI: 2.029-28.229, P=0.003) and adjuvant therapy (HR=0.212, 95%CI: 0.078-0.582, P=0.003) were independent prognostic factors. Conclusion MET-PET/CT combined with MR could predict the prognosis of DIPG patients in this prospective cohort study. Key words: Brain stem tumor; Glioma; Positron emission tomography; 11C- methionine

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来源期刊

中华神经外科杂志 Medicine-Surgery

CiteScore

0.10

自引率

0.00%

发文量

10706

期刊介绍： Chinese Journal of Neurosurgery is one of the series of journals organized by the Chinese Medical Association under the supervision of the China Association for Science and Technology. The journal is aimed at neurosurgeons and related researchers, and reports on the leading scientific research results and clinical experience in the field of neurosurgery, as well as the basic theoretical research closely related to neurosurgery.Chinese Journal of Neurosurgery has been included in many famous domestic search organizations, such as China Knowledge Resources Database, China Biomedical Journal Citation Database, Chinese Biomedical Journal Literature Database, China Science Citation Database, China Biomedical Literature Database, China Science and Technology Paper Citation Statistical Analysis Database, and China Science and Technology Journal Full Text Database, Wanfang Data Database of Medical Journals, etc.