BRAIN:18F-FLT对脑膜瘤的PET成像:肿瘤进展的预测指标

2020-12-31 MedSci原创 MedSci原创

既往研究表明,18F-PET是一种有前途的替代成像生物标志物,可用于预测未接受治疗和无症状残余脑膜瘤的后续肿瘤进展。

既往研究表明,3'-脱氧-3'-18F-氟胸苷(18F-FLT)的PET可对脑膜瘤体内细胞增殖提供非侵入性评估。这项前瞻性研究的目的是评估18F-FLT PET在预测无症状脑膜瘤后续肿瘤进展中的潜力。 43例成年患者,其中46例(例)经核磁共振诊断为阳性,6例(6例)为手术后残留脑膜瘤,在放射学监测前进行了60min动态18F-FLTPET扫描。计算示踪放射性的最大和平均肿瘤血比(TBRmax,TBRmean)。根据最新发布的二维(2D)试验终点标准和神经肿瘤反应评估(RANO)工作组相应的探索性体积测量结果定义肿瘤进展。使用独立样本t检验,Pearson相关系数,Cox回归和接收器工作特征(ROC)曲线分析。18F-FLT PET显像后的中位随访时间为18个月(范围5–33.5个月)。使用2D-RANO(n = 11)相对于体积标准(n = 10),发现疾病进展的一致性较高(91%)。使用2D-RANO标准,与疾病稳定的患者相比,进行性疾病患者的18F-FLT摄取显著增加(TBRmax,5.5±1.3对3.6±1.1,P <0.0001; TBRmean,3.5±0.8对2.4±0.7 P <0.0001)。 ROC分析得出TBRmax的最佳阈值为4.4 [敏感性82%,特异性77%,准确性78%和曲线下面积(AUC)0.871; TBRmean的P <0.0001]和2.8(敏感性82%,特异性77%,准确度78%,AUC 0.848; P = 0.001),用于将疾病进展的患者从稳定的疾病中早期区分出来。在排除残留脑膜瘤患者或疾病稳定且随访时间少于12个月的患者后,阈值保持不变,诊断准确性相似。此外,在排除绝对脑膜瘤患者或病情稳定且随访时间较短的患者时,发现绝对和相对肿瘤生长率与18F-FLT摄取之间呈正相关(r <0.513,P <0.015)。使用体积标准评估疾病进展时,诊断准确性略差于76%,而阈值保持不变。多变量分析显示,TBRmax是肿瘤进展的唯一独立预测因子(P <0.046),而年龄,性别,基线肿瘤大小,肿瘤位置,肿瘤周围水肿和残留脑膜瘤则没有影响。

这项研究表明18F-FLT PET是一种有前途的替代成像生物标志物,可用于预测未接受治疗和无症状残余脑膜瘤的后续肿瘤进展。

原文出处:

Asma Bashir, Mark B Vestergaard, Lisbeth Marner, PET imaging of meningioma with 18F-FLT: a predictor of tumour progression.

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