肺癌18F-FDG PET/CT 代谢参数的影响因素分析*

Analysis of factors influencing 18F- FDG metabolic parameters in PET/CT scan for lung cancer

    摘要
  • 摘要: 目的：探讨肺癌患者的体重指数（body mass index ，BMI）、性别对其18F-FDGPET/CT 代谢参数SUV （standardized uptake value）、SUL（standard uptake value ofl ean body mass ）的影响。方法：回顾性分析50例原发性肺癌患者18F-FDGPET/CT 显像结果。通过AW4.6 后处理工作站测量病灶部位18F-FDG代谢指SUVmean 、SUVmax；应用PETVCAR（PET volumec omputed assisted reading ，GE Healthcare）软件自动测定病灶SULmean 、SULmax、SULpeak ；另于肝右后叶实质取1 cm3感兴趣区，分别测量其 SUVmean 、SUVmax、SULmean 及SULmax，计算肺部病灶T/N 比值（病灶SUVmax/ 肝脏SUVmean 、病灶SULmax/ 肝脏SULmean 、病灶SULpeak/ 肝脏SULmean ）。 分析患者正常肝脏、肺癌病灶及T/N 比值与BMI 、性别的相关性。结果：50例患者肝脏的SUVmean 、SUVmax 与BMI呈正相关（r = 0.38、0.36，P < 0.05），其中男性组仅SUVmean 与BMI 呈正相关（r = 0.47，P < 0.05），女性组仅SUVmax 与BMI 呈正相关（r = 0.44，P < 0.05），而SULmean 及SULmax与BMI 无明显相关性（P > 0.05）。 肺癌病灶SUVmean 、SUVmax、SULmean 、SULmax及SUL peak 与BMI 均无明显相关性（P > 0.05），与不同性别组相关趋势相同。而肺癌病灶的T/N 比值中仅T/N 比值（SUVmax）与BMI 呈负相关（r =-0.28，P < 0.05），而不同性别组中各T/N 比值与BMI 间无明显相关性（P > 0.05）。 结论：SUV 尤其是SUVmax 与BMI 、性别有关，而SUL 及T/N 比值（SUL ）不受患者BMI 、性别的影响，用于恶性肿瘤代谢定量分析及治疗反应评估更加客观。该结果有助于推动以SUL 为主要评价指标的PERCIST 标准的临床应用及推广。

     

    Abstract: To explore the effects of body mass index (BMI) and gender on primary lung cancer 18F-FDG uptake param -eters, standardized uptake value (SUV), and standard uptake value of lean body mass (SUL). Methods:Data of 50patients with prima -ry lung cancer confirmed by 18F-FDG positron emission tomography(PET) / computed tomography (CT) were retrospectively analyzed. AW4.6 workstation was employed to measure the SUVmean and SUVmax. Meanwhile, PETVCAR (PET Volume Computed Assisted Reading, GE Healthcare) software was used to automatically measure the SULmean, SULmax, and SULpeak. The SUVmean, SUV max, SULmean, and SULmax of the liver (central region of the right lobe) were also measured automatically by PETVCAR. Afterward, T/N ratios (lesion SUVmax/liver SUVmean, lesion SULmax/ liver SULmean, and lesion SULpeak/liver SULmean) of the lung cancer lesions were calculated. Correlations of the 18F-FDG metabolic parameters with BMI and gender of the patients were analyzed. Results: Liver SUVmean and SUVmax demonstrated significant positive correlations with BMI in all the patients ( γ =0.38and 0.36, P<0.05), and the SUVmean and SUVmax were positively correlated with BMI in male and female groups ( γ =0.47and 0.44, P<0.05), respective -ly. By contrast, no correlation existed between the liver SULmean and SULmax and BMI ( P>0.05). No significant correlation was not -ed between the SUVmean, SUVmax, SULmean, SULmax, and SULpeak of the lung cancer lesions and BMI ( P>0.05). The correlation trend is the same as that in different gender groups. Only the SUVmax T/N ratio of the lung cancer lesions showed a significant nega -tive correlation with BMI ( γ =−0.29, P<0.05). The T/N ratios did not correlate with BMI in the different gender groups ( P>0.05). Con -clusion: Patient BMI and gender mainly affect SUV values, particularly SUVmax, by contrast, patient BMI and gender did not signifi -cantly influence SUL and T/N ratio (SUL). Hence, SUL can be more suitable to quantitatively analyze and assess treatment response objectively. This result will be helpful to the clinical application and promotion of PERCIST, which evaluates treatment response mainly by SUL.

     

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