基于FDG PET/CT的SUVpeak与肿瘤中心距离在预测乳腺癌新辅助化疗反应中的临床价值

Clinical value of SUVpeak-to-tumor centroid distance on FDG PET/CT for predicting neoadjuvant chemotherapy response in patients with breast cancer

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CANCER IMAGING

影响因子:3.5

分区:医学2区 / 肿瘤学2区核医学2区

发表日期:2024 Oct 11

作者: Sun-Pyo Hong, Sang Mi Lee, Ik Dong Yoo, Jong Eun Lee, Sun Wook Han, Sung Yong Kim, Jeong Won Lee

DOI: 10.1186/s40644-024-00787-4

摘要

研究发现，癌症病灶的最大代谢活性在癌症进展过程中逐渐向病灶边缘偏移，因此，归一化的放射性示踪剂摄取热点到肿瘤中心（NHOC）和肿瘤周边（NHOP）的距离被提出作为反映癌症侵袭性的新型F-18氟脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）参数。本研究旨在探讨NHOC和NHOP参数是否能预测乳腺癌患者的病理反应和无进展生存期（PFS）。本研究回顾性纳入135名接受术前FDG PET/CT并接受新辅助化疗（NAC）和手术切除的乳腺癌患者。对PET/CT图像中最大SUV、峰值SUV到肿瘤中心的归一化距离（NHOCmax和NHOCpeak）以及到肿瘤边界的归一化距离（NHOPmax和NHOPpeak）进行测量，此外还分析了常规PET/CT参数。在135例患者中，有32例（23.7%）达到了病理完全缓解（pCR），随访期间有34例（25.2%）发生事件。ROC曲线分析显示，NHOCmax在预测pCR方面的曲线下面积（AUC）最高（0.710），次之是NHOCpeak（0.694）。多变量逻辑回归分析表明，NHOCmax、NHOCpeak和NHOPmax为pCR的独立预测因素（p<0.05）。多变量生存分析显示，NHOCpeak（p=0.026）与无进展生存期（PFS）相关，且与代谢肿瘤体积一同作为独立预测因子，NHOCpeak较高的患者预后较差。预处理FDG PET/CT中的NHOCpeak是预测乳腺癌NAC反应和生存的潜在影像参数。

Abstract

Since it has been found that the maximum metabolic activity of a cancer lesion shifts toward the lesion edge during cancer progression, normalized distances from the hot spot of radiotracer uptake to tumor centroid (NHOC) and tumor perimeter (NHOP) have been suggested as novel F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) parameters that can reflect cancer aggressiveness. This study aimed to investigate whether NHOC and NHOP parameters could predict pathological response to neoadjuvant chemotherapy (NAC) and progression-free survival (PFS) in breast cancer patients.This study retrospectively enrolled 135 female patients with breast cancer who underwent pretreatment FDG PET/CT and received NAC and subsequent surgical resection. From PET/CT images, normalized distances of maximum SUV and peak SUV-to-tumor centroid (NHOCmax and NHOCpeak) and -to-tumor perimeter (NHOPmax and NHOPpeak) were measured, in addition to conventional PET/CT parameters.Of 135 patients, 32 (23.7%) achieved pathological complete response (pCR), and 34 (25.2%) had events during follow-up. In the receiver operating characteristic (ROC) curve analysis, NHOCmax showed the highest area under the ROC curve value (0.710) for predicting pCR, followed by NHOCpeak (0.694). In the multivariate logistic regression analysis, NHOCmax, NHOCpeak, and NHOPmax were independent predictors for pCR (p < 0.05). In the multivariate survival analysis, NHOCpeak (p = 0.026) was an independent predictor for PFS along with metabolic tumor volume, with patients having higher NHOCpeak showing worse PFS.NHOCpeak on pretreatment FDG PET/CT could be a potential imaging parameter for predicting NAC response and survival in patients with breast cancer.