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首页> 外文期刊>Acta Radiologica >Preliminary assessment of dynamic contrast-enhanced CT implementation in pretreatment FDG-PET/CT for outcome prediction in head and neck tumors.
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Preliminary assessment of dynamic contrast-enhanced CT implementation in pretreatment FDG-PET/CT for outcome prediction in head and neck tumors.

机译：在FDG-PET / CT预处理中动态对比增强CT实施对头颈部肿瘤预后的初步评估。

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BACKGROUND: Recently published data show some controversy concerning the impact of [18F]-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) in predicting head and neck tumors (HNT) outcome. Assessment of tumor blood supply parameters using dynamic contrast-enhanced CT (DCE-CT) may deliver additional information concerning this important question. PURPOSE: To evaluate the contribution of DCE-CT implemented in pretherapeutic FDG-PET/CT protocol for prognosis prediction in patients with HNT. MATERIAL AND METHODS: Ten consecutive patients (median age 50 years, range 47-74 years) with histologically proven HNT underwent FDG-PET/CT with DCE-CT before treatment. FDG uptake was measured by maximum standardized uptake value (SUV(max)). Relative tumor blood volume (rTBV) was determined from DCE-CT using Patlak analysis. Intratumoral heterogeneity was assessed by means of lacunarity analysis. Obtained values were compared with time-to-progression and overall survival. PET and DCE-CT images were compared on a pixel-by-pixel basis using Pearson coefficient of correlation. RESULTS: Three patients with lower FDG uptake (SUV(max): 8+/-1) and five patients with higher FDG uptake (SUV(max): 15+/-4, P=0.004) were free of local recurrence for 24 months. Two groups of patients with significantly differing lower (group A: 0.37+/-0.02, n=6) and higher (group B: 0.52+/-0.01, n=4; P<0.01), tumor heterogeneity (lacunarity) were identified. Corresponding mean rTBV was higher in group A (9.6+/-1.8 ml/100 ml) than in group B (6.2+/-0.6 ml/100 ml). All six patients with homogeneous tumor blood supply (lower lacunarity) and higher rTBV were free of local recurrence during 24 months, while two of four patients with heterogeneous tumor blood supply (higher lacunarity) and lower rTBV died during follow-up due to tumor relapse. A weak correlation between FDG-PET and DCE-CT rTBV was observed (R(2)=0.1). CONCLUSION: FDG-PET/CT and DCT-CT are complementary methods for surveillance assessment in patients with HNT. Implementation of DCE-CT in the pretreatment FDG-PET/CT protocol may improve tumor outcome prediction.
机译：背景：最近发表的数据显示了关于[18F]-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET / CT）在预测头颈部肿瘤（HNT）结局方面的影响的争议。使用动态对比增强CT（DCE-CT）评估肿瘤血液供应参数可能会提供有关此重要问题的其他信息。目的：评估在治疗前FDG-PET / CT方案中实施的DCE-CT对HNT患者预后的贡献。材料和方法：治疗前连续10例经组织学证实为HNT的患者（中位年龄50岁，范围47-74岁）接受DCE-CT FDG-PET / CT治疗。通过最大标准化摄取值（SUV（max））测量FDG摄取。使用Patlak分析从DCE-CT确定相对肿瘤血容量（rTBV）。通过腔隙分析法评估肿瘤内异质性。将获得的值与进展时间和总生存期进行比较。使用Pearson相关系数逐个像素比较PET和DCE-CT图像。结果：三名FDG摄取量较低的患者（SUV（最大值）：8 +/- 1）和五名FDG摄取量较高的患者（SUV（最大值）：15 +/- 4，P = 0.004）无局部复发24个月。两组患者的肿瘤异质性（腔隙性）较低（A组：0.37 +/- 0.02，n = 6）和较高（B组：0.52 +/- 0.01，n = 4; P <0.01）明显不同。 。 A组（9.6 +/- 1.8 ml / 100 ml）的相应平均rTBV高于B组（6.2 +/- 0.6 ml / 100 ml）。六个均质肿瘤血液供应（较低的腔隙性）和较高rTBV的患者在24个月内无局部复发，而四分之二均肿瘤血液供应（较高的腔隙性）和较低rTBV的患者中有两个因肿瘤复发而在随访期间死亡。观察到FDG-PET和DCE-CT rTBV之间的相关性较弱（R（2）= 0.1）。结论：FDG-PET / CT和DCT-CT是HNT患者监测评估的补充方法。在预处理FDG-PET / CT方案中实施DCE-CT可改善肿瘤预后。

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