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  • [Medicine (Baltimore).] Prognostic value of metabolic parameters measured by pretreatment dual-time-point 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with intrahepatic or perihilar cholangiocarcinoma: A STROBE study

    2021년 07월호
    [Medicine (Baltimore).] Prognostic value of metabolic parameters measured by pretreatment dual-time-point 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with intrahepatic or perihilar cholangiocarcinoma: A STROBE study

    순천향대병원 / 황재필, 박정미*

  • 출처
    Medicine (Baltimore).
  • 등재일
    2021 May 28
  • 저널이슈번호
    100(21):e26015. doi: 10.1097/MD.0000000000026015.
  • 내용

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    Abstract
    The purpose of this study was to determine the glucose metabolism at delay phase measured by pretreatment dual-time-point 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/ computed tomography (CT) provides prognostic information independent of well-known prognostic factors in patients with intrahepatic or perihilar cholangiocarcinoma (ICC or PCC).From July 2012 to December 2017, 55 patients (men 27, women 28, mean age 68 ± 11 years) with pathologically proven ICC or PCC were enrolled in this retrospective study. The dual-time-point 18F-FDG PET/CT as part of a staging workup was performed in all patients. The patient's data includes age, sex, serum CA19-9, presence of LN or distant metastasis, early SUVmax (early maximum standardized uptake value [eSUV]), delay SUVmax (delay maximum standardized uptake value [dSUV]), retention index of SUVmax (percent change of maximum standardized uptake values [ΔSUV]), neutrophil to lymphocyte ratio (NLR) and histopathology including pCEA, p53, Ki-67 index. The analysis of the relationship between metabolic parameters and survival was done using the Kaplan-Meier curve and Cox proportional hazards regression model.Median survival for all patients was 357 days. Median early and delay SUVmax was 5.2 (range: 2.0-21.4) and 6.5 (range 2.7-24.5), respectively. The overall survival was found to be significantly related to eSUV, dSUV, ΔSUV, age, serum CA19-9 and NLR in univariate analysis. In multivariate analysis, dSUV (P = .014, 95%CI; 1.30-10.7, HR 3.74) and ΔSUVmax (P = .037, 95%CI; 1.05-6.12, HR 2.5) were independent factors of overall survival. Kaplan-Meier curve analysis clearly showed the significant difference of overall survival between 2 groups (high eSUV, low eSUV + high ΔSUV vs low eSUV and ΔSUV, P < .001) among the comparisons of the SUV parameters on FDG PET. In the receiver operating characteristic analysis using combinations of the SUV parameters, the 2 groups [eSUV + ΔSUV (P = .0001, area under the curve [AUC] 0.68) and dSUV + ΔSUV (P = .0002, AUC 0.71)] showed significantly larger AUC than the other groups applying eSUV or dSUV alone (AUC 0.61 and AUC 0.68).dSUV and ΔSUV on pretreatment dual-time-point 18F-FDG PET/CT can be useful parameters in the prediction of survival in patients with ICC or PCC.

     

     

    Affiliations

    Jae Pil Hwang  1 , Jong Ho Moon  2 , Hee Kyung Kim  3 , Min Hee Lee  4 , Chae Hong Lim  5 , Soo Bin Park  5 , Joon-Kee Yoon  6 , Jung Mi Park  1
    1 Departments of Nuclear Medicine.
    2 Departments of Internal Medicine.
    3 Departments of Pathology.
    4 Departments of Radiology, Soonchunhyang University Hospital Bucheon, Bucheon.
    5 Departments of Nuclear Medicine, Soonchunhyang University Hospital Seoul, Seoul.
    6 Department of Nuclear Medicine, Ajou University Medical Center, Suwon, Republic of Korea.

  • 연구소개
    간문부 담관암과 간내 담관암 환자의 치료 전 FDG PET/CT 주사 후 1시간영상과 2시간 지연영상에서 eSUV(조기영상)와 dSUV(지연영상), △SUV를 구하고 다변량분석과 생존분석을 하였습니다. 결과 high eSUV, high dSUV or high△SUV군 (eSUV≥7.2, dSUV≥7.3, or △SUV≥32%)일 때 생존분석의 사망예측이 유의하게 높았습니다. 지연PET영상을 추가할 때 dSUV뿐만아니라 △SUV도 생존분석에서 유익한 정보를 제공하리가 생각합니다.
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