방사선의학 웹진

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A는 거대 대사불균질성이 낮은 환자의 영상이며, B는 거대 대사불균질성이 높은 환자의 영상이다. A 환자는 재발의 가능성이 높지 않고, B 환자는 재발의 가능성이 높다고 볼 수 있다.​

Abstract

PURPOSE:

This study aimed to develop a novel quantification method for intratumoral metabolic macroheterogeneity (IMMH) on F-FDG PET/CT and evaluate its prognostic significance in pathologic N0 (pN0) squamous cell lung carcinoma (SQCLC) patients.

PATIENTS AND METHODS:

A total of 83 patients who underwent pretreatment F-FDG PET/CT and were diagnosed with pN0 SQCLC after curative surgery were examined. Patients with tumor measuring greater than 2 cm were included. Metabolic parameters (SUVmax, metabolic tumor volume, and total lesion glycolysis) for the primary lesions were calculated on the F-FDG PET/CT, and IMMH was quantified as the macroheterogeneity factor (MHF), defined as surface/spherical surface area having volume of the primary tumor multiplied by the sphericity. Heterogeneity of the primary tumor was also visually assessed (visual heterogeneity score) and compared with MHF. Univariate and multivariate analyses for recurrence were performed using the Cox proportional hazards regression.

RESULTS:

Recurrence was observed in 27 (32.5%) of 83 patients during follow-up period (37.6 ± 25.5 months). Significant correlations were observed between the visual heterogeneity score and the MHF (R = 0.534, P < 0.001). Macroheterogeneity factor was significantly higher in patients who experienced recurrence (median, 1.073 vs 1.016; P = 0.004). Univariate analysis showed that MHF was only significant prognostic factor for recurrence (P = 0.019), and multivariate analysis after adjusting for age, sex, tumor size, histologic grade, and pathologic T stage, high MHF exhibited an association with increased risk of recurrence.

CONCLUSIONS:

New quantification method for IMMH on F-FDG PET/CT was developed, and the heterogeneity parameter MHF was well correlated with visual heterogeneity. Macroheterogeneity factor on pretreatment F-FDG PET/CT was the sole prognostic factor predicting recurrence in pN0 SQCLC patients.

Author information

 Kim DH1, Jung JH, Son SH, Kim CY, Jeong SY, Lee SW, Lee J, Ahn BC.

1From the Department of Nuclear Medicine, Kyungpook National University School of Medicine and Hospital, Daegu, Republic of Korea.