齐齐哈尔医学院学报
齊齊哈爾醫學院學報
제제합이의학원학보
JOURNAL OF QIQIHAR MEDICAL COLLEGE
2015年
24期
3590-3594
,共5页
钱江%冯彦林%李雯%解飞%孙静
錢江%馮彥林%李雯%解飛%孫靜
전강%풍언림%리문%해비%손정
18 F-FDG PET-CT%乳腺癌%新辅助化疗%肿瘤代谢体积( MTV)%最大标准摄取值( SUVmax )
18 F-FDG PET-CT%乳腺癌%新輔助化療%腫瘤代謝體積( MTV)%最大標準攝取值( SUVmax )
18 F-FDG PET-CT%유선암%신보조화료%종류대사체적( MTV)%최대표준섭취치( SUVmax )
18 F-FDG PET-CT%breast cancer%Neoadjuvant chemotherapy%Metabolic tumor volume ( MTV)%Maximum standard uptake value( SUVmax)
目的：探讨早期应用18 F-FDG PET／CT肿瘤代谢体积（ metabolic tumor volume，MTV）评价乳腺癌新辅助化疗疗效的价值；比较MTV与最大标准摄取值（ maximum standard uptake value，SUVmax ）在预测化疗疗效方面的效能，选择适合评价疗效的指标及预测值。方法前瞻性研究初治乳腺癌患者41例，在新辅助化疗前、第1疗程结束后及第2疗程结束后行18 F-FDG PET-CT显像并计算其SUVmax的变化率，在PET图像中，分别选择SUV＝1．5及2．5为边界值扣除本底后，计算不同化疗时期MTV的变化率，并且根据化疗前肿瘤长径＜2．5 cm及≥2．5分组分别计算MTV值、SUVmax的变化率。结果以SUV＝2．5为边界时，新辅助化疗第1程结束后⊿SUVmax1％以及第2程结束后⊿SUVmax2％、⊿MTV22％有效组与无效组均有显著差异（P值均＜0．05）；根据ROC曲线得到⊿MTV22％最佳预测疗效的值为68．0％（灵敏度为100％，特异性为53．3％），⊿SUVmax1％最佳预测疗效的值为45．5％（灵敏度为60．0％，特异性为86．7％），⊿SUVmax2％最佳预测疗效的值为54．7％（灵敏度80．0％，特异性86．7％）。在化疗前肿瘤长径＜2．5 cm的分组中，以SUV＝1．5为边界时，新辅助化疗第1程结束后⊿SUVmax1％以及第2程结束后⊿SUVmax2％、⊿MTV12％有效组与无效组有显著差异（P值均＜0．05）；根据ROC曲线得到⊿MTV12％最佳预测疗效的值为88．2％（灵敏度75．0％，特异性83．3％），⊿ SUVmax1％最佳预测疗效的值为45．6％（灵敏度为75．0％，特异性为91．7％），⊿SUVmax2％最佳预测疗效的值为63．4％（灵敏度87．5％，特异性100％）。结论 MTV早期评价乳腺癌新辅助化疗疗效、预测病理反应是可行的，以SUV＝2．5为边界时，第2疗程结束后的⊿MTV22％下降68％能预测病理反应，第1疗程结束后的⊿SUVmax1％下降37．1％、第2疗程结束后的⊿SUVmax2％下降46．4％均能预测病理反应。且当肿瘤化疗前长径＜2．5 cm，以SUV＝1．5为边界时，第2疗程结束后的⊿MTV12％下降88．2％也能预测病理反应，⊿SUVmax1％下降45．6％、第2疗程结束后的⊿SUVmax2％下降63．4％均能预测病理反应。乳腺癌病灶MTV值评估效能并不优于⊿SUVmax。
目的：探討早期應用18 F-FDG PET／CT腫瘤代謝體積（ metabolic tumor volume，MTV）評價乳腺癌新輔助化療療效的價值；比較MTV與最大標準攝取值（ maximum standard uptake value，SUVmax ）在預測化療療效方麵的效能，選擇適閤評價療效的指標及預測值。方法前瞻性研究初治乳腺癌患者41例，在新輔助化療前、第1療程結束後及第2療程結束後行18 F-FDG PET-CT顯像併計算其SUVmax的變化率，在PET圖像中，分彆選擇SUV＝1．5及2．5為邊界值釦除本底後，計算不同化療時期MTV的變化率，併且根據化療前腫瘤長徑＜2．5 cm及≥2．5分組分彆計算MTV值、SUVmax的變化率。結果以SUV＝2．5為邊界時，新輔助化療第1程結束後⊿SUVmax1％以及第2程結束後⊿SUVmax2％、⊿MTV22％有效組與無效組均有顯著差異（P值均＜0．05）；根據ROC麯線得到⊿MTV22％最佳預測療效的值為68．0％（靈敏度為100％，特異性為53．3％），⊿SUVmax1％最佳預測療效的值為45．5％（靈敏度為60．0％，特異性為86．7％），⊿SUVmax2％最佳預測療效的值為54．7％（靈敏度80．0％，特異性86．7％）。在化療前腫瘤長徑＜2．5 cm的分組中，以SUV＝1．5為邊界時，新輔助化療第1程結束後⊿SUVmax1％以及第2程結束後⊿SUVmax2％、⊿MTV12％有效組與無效組有顯著差異（P值均＜0．05）；根據ROC麯線得到⊿MTV12％最佳預測療效的值為88．2％（靈敏度75．0％，特異性83．3％），⊿ SUVmax1％最佳預測療效的值為45．6％（靈敏度為75．0％，特異性為91．7％），⊿SUVmax2％最佳預測療效的值為63．4％（靈敏度87．5％，特異性100％）。結論 MTV早期評價乳腺癌新輔助化療療效、預測病理反應是可行的，以SUV＝2．5為邊界時，第2療程結束後的⊿MTV22％下降68％能預測病理反應，第1療程結束後的⊿SUVmax1％下降37．1％、第2療程結束後的⊿SUVmax2％下降46．4％均能預測病理反應。且噹腫瘤化療前長徑＜2．5 cm，以SUV＝1．5為邊界時，第2療程結束後的⊿MTV12％下降88．2％也能預測病理反應，⊿SUVmax1％下降45．6％、第2療程結束後的⊿SUVmax2％下降63．4％均能預測病理反應。乳腺癌病竈MTV值評估效能併不優于⊿SUVmax。
목적：탐토조기응용18 F-FDG PET／CT종류대사체적（ metabolic tumor volume，MTV）평개유선암신보조화료료효적개치；비교MTV여최대표준섭취치（ maximum standard uptake value，SUVmax ）재예측화료료효방면적효능，선택괄합평개료효적지표급예측치。방법전첨성연구초치유선암환자41례，재신보조화료전、제1료정결속후급제2료정결속후행18 F-FDG PET-CT현상병계산기SUVmax적변화솔，재PET도상중，분별선택SUV＝1．5급2．5위변계치구제본저후，계산불동화료시기MTV적변화솔，병차근거화료전종류장경＜2．5 cm급≥2．5분조분별계산MTV치、SUVmax적변화솔。결과이SUV＝2．5위변계시，신보조화료제1정결속후⊿SUVmax1％이급제2정결속후⊿SUVmax2％、⊿MTV22％유효조여무효조균유현저차이（P치균＜0．05）；근거ROC곡선득도⊿MTV22％최가예측료효적치위68．0％（령민도위100％，특이성위53．3％），⊿SUVmax1％최가예측료효적치위45．5％（령민도위60．0％，특이성위86．7％），⊿SUVmax2％최가예측료효적치위54．7％（령민도80．0％，특이성86．7％）。재화료전종류장경＜2．5 cm적분조중，이SUV＝1．5위변계시，신보조화료제1정결속후⊿SUVmax1％이급제2정결속후⊿SUVmax2％、⊿MTV12％유효조여무효조유현저차이（P치균＜0．05）；근거ROC곡선득도⊿MTV12％최가예측료효적치위88．2％（령민도75．0％，특이성83．3％），⊿ SUVmax1％최가예측료효적치위45．6％（령민도위75．0％，특이성위91．7％），⊿SUVmax2％최가예측료효적치위63．4％（령민도87．5％，특이성100％）。결론 MTV조기평개유선암신보조화료료효、예측병리반응시가행적，이SUV＝2．5위변계시，제2료정결속후적⊿MTV22％하강68％능예측병리반응，제1료정결속후적⊿SUVmax1％하강37．1％、제2료정결속후적⊿SUVmax2％하강46．4％균능예측병리반응。차당종류화료전장경＜2．5 cm，이SUV＝1．5위변계시，제2료정결속후적⊿MTV12％하강88．2％야능예측병리반응，⊿SUVmax1％하강45．6％、제2료정결속후적⊿SUVmax2％하강63．4％균능예측병리반응。유선암병조MTV치평고효능병불우우⊿SUVmax。
Objective To evaluate the effect of neoadjuvant chemotherapy in breast cancer early applying 18 F-FDG PET/CT metabolic tumor volume ( MTV ); to Compare MTV and maximum standardized uptake value ( SUVmax) in terms of predicting the effectiveness of chemotherapy, select indicators and predictive value for evaluating efficacy.Methods A prospective study 41 cases of newly treated breast cancer patients, before neoadjuvant chemotherapy, after the first course of treatment and the second course of treatment, were performed 18 F-FDG PET-CT imaging and calculated the rate of change of its SUVmax, in PET images, selected SUV=1.5 and 2.5 as boundary value, after deducting background, calculated the rate of change of MTV in different chemotherapy periods, and according to the tumor diameter <2.5cm and ≥2.5 grouping before chemotherapy, respectively calculated MTV, and the rate of change of SUVmax.Results When SUV=2.5as boundary value,⊿SUVmax1%after the first treatment course of the neoadjuvant chemotherapy;⊿SUVmax2%and⊿MTV22%after the second treatment course, effective group and in effective group were significantly different( P<0.05);Based on the ROC curve, ⊿ MTV22% the value of optimum predictionefficacyis68.0%( sensitivity is 100% and specificityis 53.3%),⊿SUVmax1%the value of optimum predictionefficacyis 45.5%(sensitivity is 60.0% and specificity is 86.7%),⊿SUVmax2%the value of optimum prediction efficacy is 54.7%(sensitivity is 80.0%, specificity is 86.7%); In the group of tumor diameter <2.5cm before chemotherapy, SUV=1.5asboundary value,⊿SUVmax1%after the first course of neoadjuvant chemotherapy; ⊿SUVmax2% and ⊿MTV12% after the second course, effective group and in effective group are significantly different(P<0.05);Based on the ROC curve,⊿MTV12%the value of optimum prediction efficacy was 88.2% ( sensitivity is 75.0% and specificity was 83.3%),⊿SUVmax1%the value of optimum prediction efficacy was 45.6% (sensitivity was 75.0% and specificity was 91.7%),⊿SUVmax2%the value of optimum prediction efficacy was 63.4%(sensitivity was 87. 5%, specificity was 100%) .Conclusions MTV early evaluation of neoadjuvant chemotherapy and predicting pathological response in breast cancer is feasible.SUV =2.5as boundary value, after the second treatment course,⊿MTV22% declined 68%can predict pathological response, after the first course, ⊿ SUVmax1%declined 37.1%, and after thesecondcourse,⊿SUVmax2% declined 46.4% can predict pathological response. When the tumor diameter <2.5cm before chemotherapy, with SUV =1.5asboundary value, after the second course,⊿MTV12%declined 88.2%also can predict pathological response;⊿SUVmax1%declined 45.6%and after the second course,⊿ SUVmax2% declined 63.4% can predict pathological response.The evaluation effectiveness of breast lesions MTV is not better than⊿SUVmax .
