18F-FDG PET/CT代谢参数在子宫内膜癌术前风险评估中的价值

The value of 18F-FDG PET/CT metabolic parameters in preoperative risk stratification of endometrial carcinoma

    摘要
  • 摘要:
    目的回顾性分析18F-FDG PET/CT代谢参数最大标准化摄取值（SUVmax）、肿瘤代谢体积（MTV）及总糖酵解量（TLG）在预测高风险和低风险子宫内膜癌患者中的意义及诊断效能。
    方法收集2008年8月至2017年1月术前行PET/CT全身检查的44例子宫内膜癌患者的临床病理资料，根据病变的侵袭程度及临床病理特点，将患者分为高风险组（21例）和低风险组（23例）。应用美国GE PET/CT AW4.6工作站的PET VACR软件，采用百分阈值法（以SUVmax的40%为阈值）自动勾画感兴趣区，软件自动生成SUVmax、MTV和TLG。应用Mann-Whithney U检验分析高、低风险组的SUVmax、MTV和TLG之间的差别；应用受试者工作特征（ROC）曲线分析SUVmax、MTV和TLG能否预测高、低风险组及预测效能。
    结果高、低风险组的SUVmax分别为14.54±6.54、13.06±8.51，差异无统计学意义（Z=-1.163，P=0.245）。高风险组的MTV（17.86±19.32）mL和TLG（152.00±178.74）g显著高于低风险组（MTV=（7.38±5.00）mL，TLG=（54.89±80.00）g，差异均有统计学意义（Z=-2.808，P=0.005；Z=-3.395，P=0.001）；分析ROC曲线发现MTV和TLG可以预测高低风险组，而SUVmax不能预测高低风险组。分别以MTV=7.44 mL和TLG=55.52 g为截断点预测效能最佳，MTV和TLG的灵敏度、特异度、阴性预测值、阳性预测值和准确率分别为76%、61%、72%、68%、70%和81%、74%、81%、77%、78%。
    结论18F-FDG PET/CT代谢参数MTV和TLG在预测子宫内膜癌的高低风险性方面优于SUVmax。

     

    Abstract:
    ObjectiveTo investigate the importance of maxium standardized uptake value(SUVmax), metabolizable tumor volume (MTV), and total glycolysis volume (TLG) of 18F-FDG PET/CT in predicting high-and low-risk groups of patients with endometrial cancer and their diagnostic efficacy.
    MethodsWe retrospectively collected the clinical pathological data of 44 patients with endometrial cancer from August 2008 to February 2017 in the PET/CT center at our hospital. The patients were divided into high-and low-risk groups based on the degree of invasion and clinicopathological features of the disease. Region of interest was automatically delineated via the percent threshold method(40% threshold of SUVmax) by using the PET VACR software of GE PET/CT AW4.6 workstation in the United States. SUVmax, MTV, and TLG were automatically generated. Mann-Whitney U test was performed to analyze the differences between SUVmax, MTV, and TLG in the high-and low-risk groups. ROC curves were obtained to determine whether SUVmax, MTV, and TLG could predict high-and low-risk groups and to reveal their predictive power.
    ResultsThe high-and low-risk groups yielded SUVmax of 14.54±6.54 and 13.06±8.51, respectively, and their difference was not significant(Z=-1.163, P=0.245). MTV and TLG(MTV=17.86±19.32) mL, TLG=(152.00±178.74) g of the high-risk group were significantly higher than those of the low-risk group(MTV=(7.38±5.00) mL, TLG=(54.89±80.00) g, their difference was significant(Z=-2.808, P=0.005; Z=-3.395, P=0.001). The ROC curve analysis indicated that high-and low-risk groups could be predicted by MTV and TLG but not by SUVmax. The optimal prediction effectiveness was obtained at MTV=7.44 mL and TLV=55.52 g. The sensitivity, specificity, negative predictive value, positive predictive value, and precision rate were 76%, 61%, 72%, 68%, and 70% in MTV and 81%, 74%, 81%, 77%, and 78% in TLG, respectively.
    ConclusionMTV and TLG are superior to SUVmax in predicting high-and low-risk groups of endometrial cancer.

     

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