{"title":"术前18F-FDG PET/CT中代谢参数和心包脂肪搁浅对预测结直肠癌术后组织病理学和预后的贡献","authors":"Selin Soyluoglu, Busra Ozdemir Gunay","doi":"10.1007/s13139-023-00808-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to investigate the additional value of preoperative PET/CT and reveal relationships between metabolic parameters, pericolic fat stranding finding, postoperative histopathology, and overall survival in colorectal cancer (CRC).</p><p><strong>Methods: </strong>CRC patients who underwent preoperative PET/CT between January 2017-December 2021 were analyzed. Lymph nodes, organ metastases, and metabolic parameters were evaluated from PET/CT. The pericolic fat stranding was evaluated from CT component. Relationships between these factors and postoperative histopathological findings were statistically analyzed. Survival analyses were performed.</p><p><strong>Results: </strong>Ninety-one patients (59 males, 32 females) were included in the study. All tumors showed high FDG uptake (mean SUVmax 19.5 ± 9.9). SUVmax of the tumor differed significantly at T3 and T4 stages (p = 0.041). A significant correlation was found between MTV, TLG values and the differentiation degree (p = 0.005, 0.003, respectively). PET/CT predicted the N stage with a high accuracy rate (80%). PET/CT found additional metastases that changed treatment decisions in one-third of patients. A relationship was found between tumor length, surgical margin, lymphovascular invasion and pericolic fat stranding. In multivariate analysis, differentiation degree (HR = 26.1, 95%CI 1.672-408.467), MTV (HR = 0.3, 95%CI 0.071-0.841), TLG (HR = 3.5, 95%CI 1.065-11.193), and lymphovascular invasion (HR = 0.2, 95%CI 0.026-0.853, p = 0.033) were independent factors affecting overall survival.</p><p><strong>Conclusion: </strong>Preoperative PET/CT contributes to CRC management by detecting additional metastases as well as predicting prognosis and postoperative findings such as T stage, N stage and tumor differentiation. The SUVmax may differentiate between T3 and T4 tumor. Reporting of pericolic fat stranding may contribute to the estimation of lymphatic invasion and positive surgical margin.</p>","PeriodicalId":19384,"journal":{"name":"Nuclear Medicine and Molecular Imaging","volume":"57 5","pages":"223-234"},"PeriodicalIF":1.3000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504194/pdf/","citationCount":"0","resultStr":"{\"title\":\"Contribution of Metabolic Parameters and Pericolic Fat Stranding on Preoperative 18F-FDG PET/CT in Predicting Post-operative Histopathology and Outcome in Colorectal Cancer.\",\"authors\":\"Selin Soyluoglu, Busra Ozdemir Gunay\",\"doi\":\"10.1007/s13139-023-00808-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>We aimed to investigate the additional value of preoperative PET/CT and reveal relationships between metabolic parameters, pericolic fat stranding finding, postoperative histopathology, and overall survival in colorectal cancer (CRC).</p><p><strong>Methods: </strong>CRC patients who underwent preoperative PET/CT between January 2017-December 2021 were analyzed. Lymph nodes, organ metastases, and metabolic parameters were evaluated from PET/CT. The pericolic fat stranding was evaluated from CT component. Relationships between these factors and postoperative histopathological findings were statistically analyzed. Survival analyses were performed.</p><p><strong>Results: </strong>Ninety-one patients (59 males, 32 females) were included in the study. All tumors showed high FDG uptake (mean SUVmax 19.5 ± 9.9). SUVmax of the tumor differed significantly at T3 and T4 stages (p = 0.041). A significant correlation was found between MTV, TLG values and the differentiation degree (p = 0.005, 0.003, respectively). PET/CT predicted the N stage with a high accuracy rate (80%). PET/CT found additional metastases that changed treatment decisions in one-third of patients. A relationship was found between tumor length, surgical margin, lymphovascular invasion and pericolic fat stranding. In multivariate analysis, differentiation degree (HR = 26.1, 95%CI 1.672-408.467), MTV (HR = 0.3, 95%CI 0.071-0.841), TLG (HR = 3.5, 95%CI 1.065-11.193), and lymphovascular invasion (HR = 0.2, 95%CI 0.026-0.853, p = 0.033) were independent factors affecting overall survival.</p><p><strong>Conclusion: </strong>Preoperative PET/CT contributes to CRC management by detecting additional metastases as well as predicting prognosis and postoperative findings such as T stage, N stage and tumor differentiation. The SUVmax may differentiate between T3 and T4 tumor. Reporting of pericolic fat stranding may contribute to the estimation of lymphatic invasion and positive surgical margin.</p>\",\"PeriodicalId\":19384,\"journal\":{\"name\":\"Nuclear Medicine and Molecular Imaging\",\"volume\":\"57 5\",\"pages\":\"223-234\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10504194/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nuclear Medicine and Molecular Imaging\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s13139-023-00808-3\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/6/13 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nuclear Medicine and Molecular Imaging","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s13139-023-00808-3","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/13 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Contribution of Metabolic Parameters and Pericolic Fat Stranding on Preoperative 18F-FDG PET/CT in Predicting Post-operative Histopathology and Outcome in Colorectal Cancer.
Purpose: We aimed to investigate the additional value of preoperative PET/CT and reveal relationships between metabolic parameters, pericolic fat stranding finding, postoperative histopathology, and overall survival in colorectal cancer (CRC).
Methods: CRC patients who underwent preoperative PET/CT between January 2017-December 2021 were analyzed. Lymph nodes, organ metastases, and metabolic parameters were evaluated from PET/CT. The pericolic fat stranding was evaluated from CT component. Relationships between these factors and postoperative histopathological findings were statistically analyzed. Survival analyses were performed.
Results: Ninety-one patients (59 males, 32 females) were included in the study. All tumors showed high FDG uptake (mean SUVmax 19.5 ± 9.9). SUVmax of the tumor differed significantly at T3 and T4 stages (p = 0.041). A significant correlation was found between MTV, TLG values and the differentiation degree (p = 0.005, 0.003, respectively). PET/CT predicted the N stage with a high accuracy rate (80%). PET/CT found additional metastases that changed treatment decisions in one-third of patients. A relationship was found between tumor length, surgical margin, lymphovascular invasion and pericolic fat stranding. In multivariate analysis, differentiation degree (HR = 26.1, 95%CI 1.672-408.467), MTV (HR = 0.3, 95%CI 0.071-0.841), TLG (HR = 3.5, 95%CI 1.065-11.193), and lymphovascular invasion (HR = 0.2, 95%CI 0.026-0.853, p = 0.033) were independent factors affecting overall survival.
Conclusion: Preoperative PET/CT contributes to CRC management by detecting additional metastases as well as predicting prognosis and postoperative findings such as T stage, N stage and tumor differentiation. The SUVmax may differentiate between T3 and T4 tumor. Reporting of pericolic fat stranding may contribute to the estimation of lymphatic invasion and positive surgical margin.
期刊介绍:
Nuclear Medicine and Molecular Imaging (Nucl Med Mol Imaging) is an official journal of the Korean Society of Nuclear Medicine, which bimonthly publishes papers on February, April, June, August, October, and December about nuclear medicine and related sciences such as radiochemistry, radiopharmacy, dosimetry and pharmacokinetics / pharmacodynamics of radiopharmaceuticals, nuclear and molecular imaging analysis, nuclear and molecular imaging instrumentation, radiation biology and radionuclide therapy. The journal specially welcomes works of artificial intelligence applied to nuclear medicine. The journal will also welcome original works relating to molecular imaging research such as the development of molecular imaging probes, reporter imaging assays, imaging cell trafficking, imaging endo(exo)genous gene expression, and imaging signal transduction. Nucl Med Mol Imaging publishes the following types of papers: original articles, reviews, case reports, editorials, interesting images, and letters to the editor.
The Korean Society of Nuclear Medicine (KSNM)
KSNM is a scientific and professional organization founded in 1961 and a member of the Korean Academy of Medical Sciences of the Korean Medical Association which was established by The Medical Services Law. The aims of KSNM are the promotion of nuclear medicine and cooperation of each member. The business of KSNM includes holding academic meetings and symposia, the publication of journals and books, planning and research of promoting science and health, and training and qualification of nuclear medicine specialists.