^(18)F⁃FDG PET/CT代谢参数对ⅡB期宫颈癌放化疗疗效的预测价值

Predictive value of ^(18)F⁃FDG PET/CT metabolic parameters for the efficacy of chemoradio⁃therapy for stageⅡB cervical cancer

目的探讨^(18)F⁃FDG PET/CT代谢参数在ⅡB期宫颈癌放化疗疗效中的预测价值。方法回顾性队列分析29例行同步放化疗的ⅡB期宫颈癌患者,治疗前均行^(18)F⁃FDG PET/CT全身显像检查,并获取代谢参数如最大标准摄取值(maximum standardized uptake values,SUVmax)、平均标准摄取值(average standardized uptake values,SUVavg)、最小标准摄取值(minmum standardized uptake values,SUVmin)、峰值标准摄取值(peak standardized uptake values,SUVpeak)、肿瘤代谢体积(metabolic tumor volume,MTV)、病灶糖酵解总量(total lesion glycolysis,TLG),根据疗效评价标准分为放化疗敏感组和放化疗抵抗组,分析18F⁃FDG PET/CT代谢参数与ⅡB期宫颈癌放化疗疗效的关系,并采用受试者工作特征(receiver operating characteristic,ROC)曲线评估其预测放化疗疗效的价值。结果放化疗敏感组的SUVmax、SUVavg、SUVpeak、SUVmin值与放化疗抵抗组比较差异无统计学意义(均P>0.05),放化疗敏感组与放化疗抵抗组的TLG、MTV比较差异有统计学意义(P=0.025,0.009)。TLG和MTV的ROC曲线下面积分别为0.753和0.793,MTV预测放化疗疗效的敏感度、特异度和准确度分别为77.8%、81.8%和79.3%;TLG分别为66.7%、81.8%和75.3%。结论^(18)F⁃FDG PET/CT代谢参数在ⅡB期宫颈癌放化疗疗效中具有良好的预测价值。

Objective To investigate the predictive value of ^(18)F⁃FDG PET/CT metabolic parameters for the efficacy of chemoradiotherapy for stageⅡB cervical cancer.Methods A total of 29 patients with stageⅡB cervical cancer who underwent concurrent chemoradiotherapy were retrospectively analyzed on a cohort basis.Before treatment,^(18)F⁃FDG PET/CT whole body imaging examination was performed,and metabolic parameters,including maximum standardized uptake values(SUVmax),average standardized uptake values(SUVavg),minimum standardized uptake values(SUVmin),peak standardized uptake values(SUVpeak),tumor metabolic volume(MTV),and total lesion glycolysis(TLG)of the lesion,were obtained.According to the efficacy evaluation criteria,the patients were divided into the radio⁃chemotherapy sensitive group and the radio⁃chemotherapy resistant group.The relationship between ^(18)F⁃FDG PET/CT metabolic param⁃eters and the efficacy of chemoradiotherapy for stageⅡB cervical cancer was compared.The value in predicting the efficacy of chemo⁃radiotherapy was evaluated by receiver operating characteristic(ROC)curve.Results The SUVmax,SUVavg,SUVpeak and SUVmin values of the radiochemotherapy sensitive group were insignificantly different from those of the radiochemotherapy resistance group(all P>0.05),while there were statistically significant differences in TLG and MTV values between two groups(P=0.025,0.009).The area under the ROC curve of TLG and MTV were 0.753 and 0.793,respectively.The sensitivity,specificity,and accuracy of MTV in predicting the efficacy of chemoradiotherapy were 77.8%,81.8%,and 79.3%,respectively;TLG were 66.7%,81.8%,and 75.3%,respectively.Conclusions ^(18)F⁃FDG PET/CT metabolic parameters have a good predictive value for the efficacy of chemoradiotherapy for stageⅡB cervical cancer.