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핵의학
- 2022년 08월호
[Clin Nucl Med.] Total Lesion Glycolysis on 18F-FDG PET/CT Is a Better Prognostic Factor Than Tumor Dose on 90Y PET/CT in Patients With Hepatocellular Carcinoma Treated With 90Y Transarterial RadioembolizationUT Southwestern Medical Center, 연세의대 / 황상현, 홍혜석, 박미애*, 윤미진*
- 출처
- Clin Nucl Med.
- 등재일
- 2022 Jun 1
- 저널이슈번호
- 47(6):e437-e443. doi: 10.1097/RLU.0000000000004128. Epub 2022 Apr 4.
- 내용
Abstract
Purpose: This study aimed to evaluate the prognostic value of metabolic parameters on 18F-FDG PET/CT and tumor dose (TD) on posttreatment 90Y PET/CT in patients with hepatocellular carcinoma (HCC) who underwent 90Y transarterial radioembolization (TARE).Patients and methods: Forty-seven HCC patients treated with 90Y TARE were retrospectively enrolled between January 2013 and October 2018. 18F-FDG PET/CT was performed before treatment. Maximum tumor SUV-to-mean normal liver SUV ratio (TLR), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured for each patient. Voxel dosimetry was performed on 90Y PET/CT images to measure TD. The prognostic significance of metabolic parameters on 18F-FDG PET/CT, TD on 90Y PET/CT, and clinical factors for overall survival (OS) was evaluated. In addition, TD on 90Y PET/CT was analyzed in relation to the administered dose of 90Y-labeled microspheres and metabolic parameters on 18F-FDG PET/CT.
Results: The median patient age was 57 years, and 37 patients (78.7%) were men. During the follow-up period, 25 patients (53.2%) died. In univariable analysis, Barcelona Clinic Liver Cancer stage C, Child-Pugh score, TD on 90Y PET/CT, TLR, MTV, and TLG were significant prognostic factors affecting OS (P < 0.05). In multivariable analysis, Barcelona Clinic Liver Cancer stage C and high TLG on 18F-FDG PET/CT were independent prognostic factors for OS (P < 0.05). The 1-year OS rates were 72.9% in patients with low TLG and 33.3% in patients with high TLG (P < 0.05). We also found that TD on 90Y PET/CT was not correlated with the administered dose of 90Y-labeled microspheres, but negatively correlated with TLG on pretreatment 18F-FDG PET/CT (P < 0.05).
Conclusions: TLG, a parameter incorporating both the degree of 18F-FDG uptake and amount of metabolically active tumor volume on pretreatment 18F-FDG PET/CT, is a better prognostic factor than TD on 90Y PET/CT for predicting OS in HCC patients treated with 90Y TARE.
Affiliations
Sang Hyun Hwang 1 , Hye-Suk Hong 2 , Dongwoo Kim 1 , Gyoung Min Kim 3 , Hye Won Lee 4 , Misu Lee 5 , Do Young Kim 4 , Mi-Ae Park 6 , Mijin Yun 1
1 From the Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul.
2 Department of Radiology, National Cancer Center, Goyang.
3 Department of Radiology, Severance Hospital, Research Institute of Radiological Science.
4 Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul.
5 Division of Life Sciences, College of Life Science and Bioengineering, Incheon National University, Incheon, South Korea.
6 Department of Radiology, UT Southwestern Medical Center, Dallas, TX.
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편집위원
간암에서 18F-FDG PET으로 구한 TLG parameter가 90Y PET/CT 으로 얻은 종양선량 보다 환자의 예후를 더 잘 예측하게 해준다는 것을 보여준 임상연구임. 종양핵의학 및 간암관련 연구자 및 임상가에게 관심을 끌 흥미로운 연구로 생각됨.
덧글달기닫기2022-08-02 14:32:04
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