Combined morphologic-metabolic biomarkers from [18F]FDG-PET/CT stratify prognostic groups in low-risk NSCLC.

IF 1 4区医学 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Nuklearmedizin-nuclear Medicine Pub Date : 2023-10-01 Epub Date: 2023-09-11 DOI:10.1055/a-2150-4130

Katharina Deininger, Joel Niclas Raacke, Elham Yousefzadeh-Nowshahr, Cornelia Kropf-Sanchen, Bernd Muehling, Meinrad Beer, Gerhard Glatting, Ambros J Beer, Wolfgang Thaiss

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Abstract

Aim: The aim of this study was to derive prognostic parameters from 2-[¹⁸F]fluoro-2-deoxy-D-glucose ([¹⁸F]FDG-PET/CT) in patients with low-risk NSCLC and determine their prognostic value.

Methods: 81 (21 female, mean age 66 a) therapy-naive patients that underwent [18F]FDG-PET/CT before histologic confirmation of NSCLC with stadium I and II between 2008-2016 were included. A mean follow-up time of 58 months (13-176), overall and progression free survival (OS, PFS) were registered. A volume of interest for the primary tumor was defined on PET and CT images. Parameters SUV_max, PET-solidity, PET-circularity, and CT-volume were analyzed. To evaluate the prognostic value of each parameter for OS, a minimum p-value approach was used to define cutoff values, survival analysis, and log-rank tests were performed, including subgroup analysis for combinations of parameters.

Results: Mean OS was 58±28 months. Poor OS was associated with a tumor CT-volume >14.3 cm³ (p=0.02, HR=7.0, CI 2.7-17.7), higher SUV_max values >12.2 (p=0.003; HR=3.0, CI 1.3-6.7) and PET-solidity >0.919 (p=0.004; HR=3.0, CI 1.0-8.9). Combined parameter analysis revealed worse prognosis in larger volume/high SUV_max tumors compared to larger volume/lower SUV_max (p=0.028; HR=2.5, CI 1.1-5.5), high PET-solidity/low volume (p=0.01; HR=2.4, CI 0.8-6.6) and low SUV_max/high PET-solidity (p=0.02, HR=4.0, CI 0.8-19.0).

Conclusion: Even in this group of low-risk NSCLC patients, we identified a subgroup with a significantly worse prognosis by combining morphologic-metabolic biomarkers from [18F]FDG-PET/CT. The combination of SUV_max and CT-volume performed best. Based on these preliminary data, future prospective studies to validate this combined morphologic-metabolic imaging biomarker for potential therapeutic decisions seem promising.

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[18F]FDG-PET/CT的联合形态代谢生物标志物对低风险NSCLC的预后组进行分层。

目的：本研究的目的是从2-[18F]氟-2-脱氧-D-葡萄糖（[18F]FDG-PET/CT）中推导低风险NSCLC患者的预后参数，并确定其预后价值。方法：纳入2008-2016年期间，81名（21名女性，平均年龄66a）接受[18F]FDG-PET/CT治疗的未接受治疗的患者，这些患者在组织学确认为I型和II型NSCLC之前接受了[18F]FDG-PET/CT。记录了58个月（13-176）的平均随访时间、总生存期和无进展生存期（OS、PFS）。在PET和CT图像上确定了原发性肿瘤的感兴趣体积。分析了参数SUVmax、PET固体度、PET圆形度和CT体积。为了评估OS的每个参数的预后价值，使用最小p值方法来定义临界值，进行生存分析和对数秩检验，包括参数组合的亚组分析。结果：平均OS为58±28个月。OS差与肿瘤CT体积>14.3cm3（p=0.02，HR=7.0，CI 2.7-17.7）、较高的SUVmax值>12.2（p=0.003；HR=3.0，CI 1.3-6.7）和PET坚固性>0.919（p=0.004；HR=3.0，CI 1.0-8.9）相关。联合参数分析显示，与较大体积/较低SUVmax相比，较大体积/较高SUVmax肿瘤的预后较差（p=0.028；HR=2.5，CI 1.1-5.5），高PET坚固性/低体积（p=0.01；HR=2.4，CI 0.8-6.6）和低SUVmax/高PET坚固度（p=0.02，HR=4.0，CI 0.8-19.0）。结论：即使在这组低风险NSCLC患者中，我们也通过结合[18F]FDG-PET/CT的形态代谢生物标志物，确定了一个预后明显较差的亚组。SUVmax和CT容量的组合表现最好。基于这些初步数据，未来验证这种联合形态学代谢成像生物标志物的潜在治疗决策的前瞻性研究似乎很有希望。

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来源期刊

Nuklearmedizin-nuclear Medicine 医学-核医学

CiteScore

1.70

自引率

13.30%

发文量

267

审稿时长

>12 weeks

期刊介绍： Als Standes- und Fachorgan (Organ von Deutscher Gesellschaft für Nuklearmedizin (DGN), Österreichischer Gesellschaft für Nuklearmedizin und Molekulare Bildgebung (ÖGN), Schweizerischer Gesellschaft für Nuklearmedizin (SGNM, SSNM)) von hohem wissenschaftlichen Anspruch befasst sich die CME-zertifizierte Nuklearmedizin/ NuclearMedicine mit Diagnostik und Therapie in der Nuklearmedizin und dem Strahlenschutz: Originalien, Übersichtsarbeiten, Referate und Kongressberichte stellen aktuelle Themen der Diagnose und Therapie dar. Ausführliche Berichte aus den DGN-Arbeitskreisen, Nachrichten aus Forschung und Industrie sowie Beschreibungen innovativer technischer Geräte, Einrichtungen und Systeme runden das Konzept ab. Die Abstracts der Jahrestagungen dreier europäischer Fachgesellschaften sind Bestandteil der Kongressausgaben. Nuklearmedizin erscheint regelmäßig mit sechs Ausgaben pro Jahr und richtet sich vor allem an Nuklearmediziner, Radiologen, Strahlentherapeuten, Medizinphysiker und Radiopharmazeuten.

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The Medical Informatics Initiative and the Network University Medicine - Perspectives for Nuclear Medicine. Combined morphologic-metabolic biomarkers from [18F]FDG-PET/CT stratify prognostic groups in low-risk NSCLC. NuklearMedizin 2024: Abstract-Einreichung bis zum 1. November geöffnet! DGN-Forschungs- und -Förderpreise Preisverleihungen